Healthcare Provider Details

I. General information

NPI: 1164588935
Provider Name (Legal Business Name): JEFFREY B. MAGNES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 VIBORG RD
SOLVANG CA
93463-2220
US

IV. Provider business mailing address

500 W MAIN ST SUITE 16
WYCKOFF NJ
07481-1439
US

V. Phone/Fax

Practice location:
  • Phone: 805-688-6431
  • Fax:
Mailing address:
  • Phone: 201-847-9403
  • Fax: 201-847-0059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG185387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: