Provider Demographics
NPI:1750088951
Name:MAGUIRE, MARTIN PHILIP (RN)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:PHILIP
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:MARTY
Other - Middle Name:
Other - Last Name:MAGUIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2169 15TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1398
Mailing Address - Country:US
Mailing Address - Phone:415-712-3001
Mailing Address - Fax:
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95308893163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse