Provider Demographics
NPI:1396888962
Name:GUIRGUIS, MAGDY S (DC)
Entity type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:S
Last Name:GUIRGUIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 WILSHIRE BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5679
Mailing Address - Country:US
Mailing Address - Phone:310-829-7339
Mailing Address - Fax:
Practice Address - Street 1:1821 WILSHIRE BLVD STE 501
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5679
Practice Address - Country:US
Practice Address - Phone:310-829-7339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20094111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC20094Medicare ID - Type UnspecifiedMEDICARE