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Deactivated NPI 1770737785 Deactivated / Inactive NPI Male Practitioner

Earl Stanley Mack , RPT

Contractor • Rancho Cucamonga, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Earl Mack has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 05, 2008
NPI Deactivation Date March 15, 2023
Total Practice Duration ~15 Years of Practice (2008 – 2023)

Professional Overview & Biography Verified Profile Summary

Earl Mack, RPT was a registered Contractor practicing in Rancho Cucamonga, CA. Throughout an active medical career spanning 15 years, Earl Mack provided care at the practice location at 9227 HAVEN AVE until profile deactivation on 2023-03-15.

Practice Location & Contact Primary Location

Practice Address

9227 Haven Ave
Suite 300

Rancho Cucamonga, CA 917305420

Telephone 9515059929

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor in Rancho Cucamonga, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.4 Yrs
Regional Practice Density
5 Specialists

Practicing in Rancho Cucamonga, CA (480 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Contractor Primary Specialty

NUCC Taxonomy Code: 171W00000X

State License CA PT6211

A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Cameron Burnett , MSW

Counselor - Mental Health

NPI 1144471509

Master of Social Work

Denise Templeton , SLP

Speech-Language Pathologist

NPI 1245422914

Speech-Language Pathologist

Dennis Wendtland , PT

Physical Therapist

NPI 1407047434

Physical Therapist

Judi Shiba , OTR, L

Occupational Therapist

NPI 1639380876

Occupational Therapist Registered, L

Ileen Murray , MSW

Social Worker

NPI 1831353978

Master of Social Work

Melinda Peters , PTA

Physical Therapy Assistant

NPI 1851593172

Physical Therapist Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 15, 2023

Record deactivated on March 15, 2023

NPI Profile Active November 05, 2008

NPI status registered as active in NPPES database

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Updated Practice Location November 05, 2008

Registered at 9227 HAVEN AVE, SUITE 300, RANCHO CUCAMONGA, CA 917305420 (Tel: 9515059929)

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Updated Business Mailing Address November 05, 2008

Registered at 9227 HAVEN AVE, SUITE 300, RANCHO CUCAMONGA, CA 917305420 (Tel: 9515059929)

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Provider Name / Credentials Updated November 05, 2008

Recorded as EARL MACK, RPT

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 05, 2008

Contractor (License #PT6211 in CA)

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Initial NPI Registration & Enumeration November 05, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770737785
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 05, 2008
Last Update: November 05, 2008
Deactivation Date: March 15, 2023

Mailing Address

9227 Haven Ave, Suite 300

Rancho Cucamonga, CA 917305420

Phone: 9515059929

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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