Provider Demographics
NPI:1922276005
Name:GEORGE A. MACER, JR., M.D., MEDICAL CORP.
Entity Type:Organization
Organization Name:GEORGE A. MACER, JR., M.D., MEDICAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ARMEN
Authorized Official - Last Name:MACER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:562-424-9000
Mailing Address - Street 1:3918 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2666
Mailing Address - Country:US
Mailing Address - Phone:562-424-9000
Mailing Address - Fax:562-424-9067
Practice Address - Street 1:3918 LONG BEACH BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2666
Practice Address - Country:US
Practice Address - Phone:562-424-9000
Practice Address - Fax:562-424-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34983207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5239660001Medicare NSC