Provider Demographics
NPI:1265561211
Name:MAHER, JOHN FRANCIS III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANCIS
Last Name:MAHER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:FRANCIS
Other - Last Name:MEAGHER
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:22924 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3023
Mailing Address - Country:US
Mailing Address - Phone:424-328-0091
Mailing Address - Fax:424-328-0094
Practice Address - Street 1:22924 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3023
Practice Address - Country:US
Practice Address - Phone:424-328-0091
Practice Address - Fax:424-328-0094
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54565207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
330449875OtherCIGNA
330449875OtherTAX ID
G54565OtherPIN #
PA000198598OtherHIGHMARK BLUE SHIELD
CA00G545651Medicaid
180004317OtherRAILROAD MEDICARE
330449875OtherUNITED HEALTHCARE
CA00G545650OtherBLUE SHIELD
0004080884OtherAETNA
IL330449875OtherBLUE CROSS BLUE SHIELD OF
CA330449875OtherBLUE CROSS OF CALIF
WI330449875OtherTRICARE
A93307Medicare UPIN
CA00G545651Medicaid