Provider Demographics
NPI:1134943913
Name:GERALD A. MAGUIRE MD INC
Entity type:Organization
Organization Name:GERALD A. MAGUIRE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-287-0895
Mailing Address - Street 1:31103 RANCHO VIEJO RD STE D3046
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1759
Mailing Address - Country:US
Mailing Address - Phone:714-287-0895
Mailing Address - Fax:949-502-8887
Practice Address - Street 1:31103 RANCHO VIEJO RD STE D3046
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1759
Practice Address - Country:US
Practice Address - Phone:714-287-0895
Practice Address - Fax:949-502-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty