Basic Information
Provider Information
NPI: 1093829251
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAGPAYO
FirstName: JOHN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 10076
Address2:  
City: VAN NUYS
State: CA
PostalCode: 914100076
CountryCode: US
TelephoneNumber: 8055788300
FaxNumber: 8055788950
Practice Location
Address1: 9080 COLIMA RD
Address2:  
City: WHITTIER
State: CA
PostalCode: 906051600
CountryCode: US
TelephoneNumber: 5629071738
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/17/2006
LastUpdateDate: 02/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZC0500XA84513CAN Allopathic & Osteopathic PhysiciansPathologyCytopathology
207ZP0102XA84513CAY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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