Provider Demographics
NPI:1174637581
Name:MCGUINN, GREGORY JOEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:JOEL
Last Name:MCGUINN
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:6826 HATHAWAY DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-7143
Mailing Address - Country:US
Mailing Address - Phone:702-370-3930
Mailing Address - Fax:702-459-0453
Practice Address - Street 1:57675 29 PALMS HWY
Practice Address - Street 2:STE 111
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3098
Practice Address - Country:US
Practice Address - Phone:760-365-8500
Practice Address - Fax:760-365-8599
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2017-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA21603363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical