Machicado, Gustavo A
Machicado, Gustavo A is an sole proprietor health care provider with primary practice located at 18350 Roscoe Blvd Ste 604 , Northridge CA 91325-4190. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Machicado, Gustavo A can be contacted via phone (818) 885-6261.Contact Information
Primary practice address
18350 Roscoe Blvd Ste 604
Northridge CA 91325-4190
Phone: (818) 885-6261
Fax: (818) 885-8256
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G308630 | California |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | G308630 | California |
Profile Details
| NPI number | 1568434652 |
|---|---|
| LBN Legal business name | Machicado, Gustavo A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 3rd, 2006 |
| Last updated | Apr 10th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568434652 | NPPES |
| California | MEDICAID | 00G308630 |
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