Provider Demographics
NPI:1235437450
Name:JAMES A. MACER, M D A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:JAMES A. MACER, M D A PROFESSIONAL CORP
Other - Org Name:JAMES A. MACER, M.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CARNOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-449-6223
Mailing Address - Street 1:10 CONGRESS ST STE 400
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3020
Mailing Address - Country:US
Mailing Address - Phone:626-449-6223
Mailing Address - Fax:626-449-0035
Practice Address - Street 1:10 CONGRESS ST STE 400
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3020
Practice Address - Country:US
Practice Address - Phone:626-449-6223
Practice Address - Fax:626-449-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42123261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG42123Medicare UPIN