MEDICARE: MR. GARY RICHARD MCGUIRE M.F.T.

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
1	106H00000X	Marriage & Family Therapist	MFC24214	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841387024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY RICHARD MCGUIRE M.F.T.

Provider Business Mailing Address
First Line	:	2900 ADAMS ST
Second Line	:	SUITE B30-18
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-4335
Country	:	US
Telephone Number	:	951-237-4703
Fax Number	:	951-681-3993

Provider Business Practice Location Address
First Line	:	2900 ADAMS ST
Second Line	:	SUITE B30-18
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-4335
Country	:	US
Telephone Number	:	951-237-4703
Fax Number	:	951-681-3993

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/09/2007

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