Provider Demographics
NPI:1831527209
Name:MACH, ZBIGNIEW (CCP)
Entity type:Individual
Prefix:
First Name:ZBIGNIEW
Middle Name:
Last Name:MACH
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 WHISPERING TRL
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-0824
Mailing Address - Country:US
Mailing Address - Phone:812-480-6808
Mailing Address - Fax:
Practice Address - Street 1:214 CENTERVIEW DR STE 100
Practice Address - Street 2:SPECIALTY CARE
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027
Practice Address - Country:US
Practice Address - Phone:800-348-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
999047242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist