Healthcare Provider Details

I. General information

NPI: 1447380506
Provider Name (Legal Business Name): JAMES F MCGUCKIN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11411 BROOKSHIRE AVE SUITE 301
DOWNEY CA
90241-5003
US

IV. Provider business mailing address

11411 BROOKSHIRE AVE SUITE 301
DOWNEY CA
90241-5003
US

V. Phone/Fax

Practice location:
  • Phone: 562-862-4027
  • Fax:
Mailing address:
  • Phone: 562-862-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY PARKINSON
Title or Position: CEO
Credential:
Phone: 215-382-3680