Healthcare Provider Details

I. General information

NPI: 1225412521
Provider Name (Legal Business Name): JAMES DAVID MACIEL MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5430 ARLINGTON AVE
RIVERSIDE CA
92504-2505
US

IV. Provider business mailing address

5430 ARLINGTON AVE
RIVERSIDE CA
92504-2505
US

V. Phone/Fax

Practice location:
  • Phone: 951-689-2955
  • Fax: 951-717-8758
Mailing address:
  • Phone: 951-689-2955
  • Fax: 951-689-2477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA146204
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: