MEDICARE: DR. JEFFREY B. MAGNES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	G185387	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164588935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY B. MAGNES M.D.

Provider Business Mailing Address
First Line	:	500 W MAIN ST
Second Line	:	SUITE 16
City	:	WYCKOFF
State	:	NJ
Zip	:	07481-1439
Country	:	US
Telephone Number	:	201-847-9403
Fax Number	:	201-847-0059

Provider Business Practice Location Address
First Line	:	2050 VIBORG RD
Second Line	:
City	:	SOLVANG
State	:	CA
Zip	:	93463-2220
Country	:	US
Telephone Number	:	805-688-6431
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	06/18/2024

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