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NPI Code Detail

MEDICARE: CAMERON DUANE MACINNIS MD

MEDICARE: CAMERON DUANE MACINNIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA173787CA

General Provider Information

NPI Number : 1750875449
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMERON DUANE MACINNIS MD
Provider Business Mailing Address
First Line : PO BOX 276950
Second Line :
City : SACRAMENTO
State : CA
Zip : 95827-6950
Country : US
Telephone Number : 707-473-0833
Fax Number : 707-473-0843
Provider Business Practice Location Address
First Line : 717 CENTER ST
Second Line :
City : HEALDSBURG
State : CA
Zip : 95448-3604
Country : US
Telephone Number : 707-473-0833
Fax Number : 707-473-0843
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 08/05/2025

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Directions to “ CAMERON DUANE MACINNIS MD” Practice Location

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