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NPI Code Detail

MEDICARE: DR. GREGORY J. MACCHIO M.D.

MEDICARE:  DR. GREGORY J. MACCHIO  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
1207L00000XAnesthesiology Physician01044919AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2G88576OTHERCACA LICENSE

General Provider Information

NPI Number : 1386621100
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY J. MACCHIO M.D.
Provider Business Mailing Address
First Line : 27401 LOS ALTOS
Second Line : SUITE 180
City : MISSION VIEJO
State : CA
Zip : 92691-6316
Country : US
Telephone Number : 949-582-9624
Fax Number : 949-582-9626
Provider Business Practice Location Address
First Line : 27700 MEDICAL CENTER RD
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-6426
Country : US
Telephone Number : 949-364-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 08/30/2010

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Directions to “ DR. GREGORY J. MACCHIO M.D.” Practice Location

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