Provider Demographics
NPI:1417549403
Name:MACARTHUR, JOHN VICTOR
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:VICTOR
Last Name:MACARTHUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 W AVENUE J STE 206
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2954
Mailing Address - Country:US
Mailing Address - Phone:661-802-7167
Mailing Address - Fax:
Practice Address - Street 1:1331 W AVENUE J STE 206
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2954
Practice Address - Country:US
Practice Address - Phone:661-802-7167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)