Individual
DR. LINCOLN J MAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10800 MAGNOLIA AVE, KAISER PERMANENTE RIVERSIDE MEDICAL CENTER, MOB-2, RIVERSIDE, CA 92505-3043
(951) 353-3230
(951) 353-5762
Mailing address
10800 MAGNOLIA AVE, KAISER PERMANENTE RIVERSIDE MEDICAL CENTER, MOB-2, RIVERSIDE, CA 92505-3043
(951) 353-3230
(951) 353-5762
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A78157
CA
208800000X
Urology Physician
MD41134
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
620476822
TAX ID
—
Enumeration date
06/27/2006
Last updated
03/04/2010
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