Individual
MICHAEL WAYNE MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4141 RED HILL RD, VALLECITO, CA 95251
(951) 212-2777
(775) 854-6449
Mailing address
PO BOX 370, VALLECITO, CA 95251-0370
(951) 212-2777
(775) 854-6449
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
G75593
CA
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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