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

William Jacob Mack IV, MD

Individual provider Neurological Surgery Physician · NPI 1811163793

William Jacob Mack IV, MD is a Neurosurgery in Los Angeles, California. Graduated from Columbia University College of Physicians and Surgeons in 2001, 25 years ago. Practices with USC Care Medical Group Inc, a 1,371-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
25
Trained at
Columbia University College of Physicians and Surgeons
Licensed in
CA
In the registry since
2008
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

1520 San Pablo St Ste 3800
Los Angeles, CA 90033-5328
Phone: (323) 442-5720
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence A104088 (CA)

Record details

NPI number1811163793
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 1, 2008
Last updated in NPPESNovember 27, 2023
Certification dateAugust 25, 2020

Medicare enrollment

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

Medicare specialtyNEUROSURGERY
Also practisesDIAGNOSTIC RADIOLOGY
Medical schoolCOLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduated 2001 (25 years in practice)
Group practice Usc Care Medical Group Inc — 1371 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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