Individual
DR. THOMAS J MAGRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1321 COTTONWOOD ST, SUITE 203, WOODLAND, CA 95695-5131
(530) 666-1631
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
(916) 379-2861
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G59229
CA
208C00000X
Colon & Rectal Surgery Physician
Primary
G59229
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G592290
BLUE SHIELD
CA
05
—
00G592290
—
CA
01
—
P00745240
MEDICARE RAILROAD CARRIER
CA
Enumeration date
07/20/2006
Last updated
09/05/2017
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