Mackie, George Gary

Mackie, George Gary is an individual health care provider with primary practice located at 1120 W La Veta Ave Ste. 100, Orange CA 92868-4231. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Mackie, George Gary can be contacted via phone (714) 289-4704.

Contact Information

Primary practice address
1120 W La Veta Ave Ste. 100 Orange CA 92868-4231
Phone: (714) 289-4704
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X A39120 California

Profile Details

NPI number 1831198936
LBN Legal business name Mackie, George Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831198936 NPPES
California MEDICAID 00A391200

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