Provider Demographics
NPI:1184177347
Name:MICHAEL J. MAGUIRE ACUPUNCTURIST, INC.
Entity type:Organization
Organization Name:MICHAEL J. MAGUIRE ACUPUNCTURIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:310-589-0828
Mailing Address - Street 1:28990 PCH
Mailing Address - Street 2:BUILDING B STE 211
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265
Mailing Address - Country:US
Mailing Address - Phone:310-589-0828
Mailing Address - Fax:310-589-4842
Practice Address - Street 1:28990 PCH
Practice Address - Street 2:BUILDING B STE 211
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265
Practice Address - Country:US
Practice Address - Phone:310-589-0828
Practice Address - Fax:310-589-4842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty