Provider Demographics
NPI:1144334145
Name:MAKSY, MAGDY (MD)
Entity type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:
Last Name:MAKSY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-2941
Mailing Address - Country:US
Mailing Address - Phone:559-733-7336
Mailing Address - Fax:559-741-7256
Practice Address - Street 1:500 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-2941
Practice Address - Country:US
Practice Address - Phone:559-733-7336
Practice Address - Fax:559-741-7256
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38931207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A389310Medicaid
CAA28761Medicare UPIN
CA00A389310Medicare PIN