Provider Demographics
NPI:1144300302
Name:MAGUIRE, GERALD (MD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:GERALD A. MAGUIRE MD INC
Mailing Address - Street 2:31103 RANCHO VIEJO RD, , SUITE D3046
Mailing Address - City:SAN JUAN CAPSTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1759
Mailing Address - Country:US
Mailing Address - Phone:949-212-8339
Mailing Address - Fax:949-502-8887
Practice Address - Street 1:GERALD A. MAGUIRE MD INC
Practice Address - Street 2:31103 RANCHO VIEJO RD, SUITE D3046
Practice Address - City:SAN JUAN CAPISTRACO
Practice Address - State:CA
Practice Address - Zip Code:92675-1759
Practice Address - Country:US
Practice Address - Phone:949-212-8339
Practice Address - Fax:949-502-8887
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2024-12-30
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Provider Licenses
StateLicense IDTaxonomies
CAG750842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG75084BMedicare PIN