Healthcare Provider Details

I. General information

NPI: 1144334145
Provider Name (Legal Business Name): MAGDY MAKSY M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S SANTA FE AVE
VISALIA CA
93292-2941
US

IV. Provider business mailing address

500 S SANTA FE AVE
VISALIA CA
93292-2941
US

V. Phone/Fax

Practice location:
  • Phone: 559-733-7336
  • Fax: 559-741-7256
Mailing address:
  • Phone: 559-733-7336
  • Fax: 559-741-7256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA38931
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: