MEDICARE: IVAR MAC SZPER MD

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	207T00000X	Neurological Surgery Physician	G39971	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
2	WG39971A	OTHER	CA	PPIN
3	W19727	OTHER	CA	GROUP ID

General Provider Information

NPI Number	:	1457305658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVAR MAC SZPER MD

Provider Business Mailing Address
First Line	:	2888 LONG BEACH BLVD
Second Line	:	SUITE 240
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1530
Country	:	US
Telephone Number	:	562-595-7696
Fax Number	:	562-490-3846

Provider Business Practice Location Address
First Line	:	2888 LONG BEACH BLVD
Second Line	:	SUITE 240
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1530
Country	:	US
Telephone Number	:	562-595-7696
Fax Number	:	562-490-3846

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	04/19/2011

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Directions to “ IVAR MAC SZPER MD” Practice Location

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