Provider Demographics
NPI:1629187372
Name:DESMOND E. MCGUIRE, M. D., INC.
Entity Type:Organization
Organization Name:DESMOND E. MCGUIRE, M. D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DESMOND
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-543-6020
Mailing Address - Street 1:PO BOX 11918
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92711-1918
Mailing Address - Country:US
Mailing Address - Phone:714-835-3709
Mailing Address - Fax:714-835-3287
Practice Address - Street 1:1401 N TUSTIN AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8644
Practice Address - Country:US
Practice Address - Phone:714-543-6020
Practice Address - Fax:714-543-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75183207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A751830Medicaid
CA00A751830Medicaid