Provider Demographics
NPI:1508180571
Name:MACCHIA, CARL JAMES (CO)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:JAMES
Last Name:MACCHIA
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18011 MITCHELL S
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6007
Mailing Address - Country:US
Mailing Address - Phone:949-261-3000
Mailing Address - Fax:949-477-9679
Practice Address - Street 1:18011 MITCHELL S
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6007
Practice Address - Country:US
Practice Address - Phone:949-261-3000
Practice Address - Fax:949-477-9679
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist