Healthcare Provider Details

I. General information

NPI: 1114106689
Provider Name (Legal Business Name): JOHN F. MCGUIRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 E. ELDER STREET SUITE 202
FALLBROOK CA
92028-3083
US

IV. Provider business mailing address

521 E. ELDER STREET SUITE 202
FALLBROOK CA
92028-3083
US

V. Phone/Fax

Practice location:
  • Phone: 760-723-1100
  • Fax: 760-723-2180
Mailing address:
  • Phone: 760-723-1100
  • Fax: 760-723-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA91145
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberA91145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: