Provider Demographics
NPI:1225412521
Name:MACIEL, JAMES DAVID (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:MACIEL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 N PACIFIC COAST HWY STE 1420
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-5648
Mailing Address - Country:US
Mailing Address - Phone:877-878-3289
Mailing Address - Fax:
Practice Address - Street 1:222 N PACIFIC COAST HWY STE 1420
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-5648
Practice Address - Country:US
Practice Address - Phone:877-878-3289
Practice Address - Fax:877-817-3227
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA146204208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery