Individual
DR. GORDON ANDREW MACBETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
414 G ST STE 221, MARYSVILLE, CA 95901-5670
(530) 749-6650
(530) 749-6653
Mailing address
414 G ST STE 221, MARYSVILLE, CA 95901-5670
(530) 749-6650
(530) 749-6653
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
G59779
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G597790
BLUE SHIELD PIN #
CA
05
—
1629185228
—
CA
Enumeration date
08/23/2006
Last updated
01/14/2013
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