Provider Demographics
NPI:1881633063
Name:MAGUIRE, MICHAEL J (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:7624 PAINTER AVE
Mailing Address - Street 2:#100
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2357
Mailing Address - Country:US
Mailing Address - Phone:562-945-9333
Mailing Address - Fax:562-945-8533
Practice Address - Street 1:7624 PAINTER AVE
Practice Address - Street 2:#100
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2357
Practice Address - Country:US
Practice Address - Phone:562-945-9333
Practice Address - Fax:562-945-8533
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A4248207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC64494Medicare UPIN