Dr Mark Anthony Dimaggio Jr, | |
4445 Magnolia Ave, Riverside, CA 92501-4199 | |
(951) 788-3000 | |
Not Available |
Full Name | Dr Mark Anthony Dimaggio Jr |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 4445 Magnolia Ave, Riverside, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457001315 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 135871 (California) | Primary |
Entity Name | Golden State Providers, A Medical Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366859449 PECOS PAC ID: 7012212475 Enrollment ID: O20160223000539 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark Anthony Dimaggio Jr, 5064 Myrtle Ave, Riverside, CA 92506-1423 Ph: (951) 202-2514 | Dr Mark Anthony Dimaggio Jr, 4445 Magnolia Ave, Riverside, CA 92501-4199 Ph: (951) 788-3000 |
Mr. Steven Frank Goins, CRNA, RN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3575 Gay Way, Riverside, CA 92504 Phone: 951-785-5901 | |
Dino M Mendoza, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 10800 Magnolia Ave, Riverside, CA 92505 Phone: 909-353-2000 | |
Cliff Fontelera, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 10800 Magnolia Ave, Riverside, CA 92505 Phone: 909-353-2000 | |
Emely Rebekah Garcia, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4445 Magnolia Ave, Riverside, CA 92501 Phone: 951-870-3189 | |
Charles B Robison, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 10800 Magnolia Ave, Riverside, CA 92505 Phone: 909-353-2000 | |
Karla S Hoksbergen, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 10800 Magnolia Ave, Riverside, CA 92505 Phone: 909-353-2000 | |
Ruchama Barkai, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 4445 Magnolia Ave, Riverside, CA 92501 Phone: 410-585-7241 |