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Individual
MARY ANN MAGOUN
Active
Individual
MARY ANN MAGOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
20A8657
CA
208000000X
Pediatrics Physician
Primary
20A8657
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX86570
—
CA
01
—
20A8657
STATE LICENSE
CA
Enumeration date
07/21/2006
Last updated
09/01/2020
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