Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Douglas K. Mack, MD

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1124195045

Douglas K. Mack, MD is a Physical Medicine and Rehabilitation in Fontana, California. Graduated from University of California, Irvine, California College of Medicine in 1996, 30 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
30
Trained at
University of California, Irvine, California College of Medicine
Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9961 Sierra Ave
Fontana, CA 92335-6720
Phone: (909) 427-3910
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence A65889 (CA)

Record details

NPI number1124195045
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 29, 2006
Last updated in NPPESDecember 1, 2021
Mailing address9961 Sierra Ave, Fontana, CA 92335-6720

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolUNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated 1996 (30 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Fontana