Provider Demographics
NPI:1003849233
Name:MAJCHER, GRZEGORZ (MD)
Entity Type:Individual
Prefix:DR
First Name:GRZEGORZ
Middle Name:
Last Name:MAJCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3858 W CARSON ST
Mailing Address - Street 2:SUITE 123
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6709
Mailing Address - Country:US
Mailing Address - Phone:310-316-1015
Mailing Address - Fax:310-316-1059
Practice Address - Street 1:3858 W CARSON ST
Practice Address - Street 2:SUITE 123
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6709
Practice Address - Country:US
Practice Address - Phone:310-316-1015
Practice Address - Fax:310-316-1059
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54351174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A543510Medicaid
CAA54351Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CA00A543510Medicaid