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General NPI Number Information
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NPI Number | 1528164332
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Entity Type | Organization
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Legal Business Name | STEVEN D MACINA DO A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 8201 NEWMAN AVE SUITE 200
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-7059
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Country | US
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Telephone | 714-375-5405
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Fax | 714-375-5408
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Provider Business Mailing Address
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Address Line | 25421 SPINDLEWOOD
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1901
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Country | US
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Telephone | 714-375-2077
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Fax | 714-375-2078
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN D MACINA
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Credential | DO
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Telephone | 714-484-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20A6625
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License Number State | CA
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