Individual
ATHANASIOS MAGIMBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 BESSIE AVE, STE 105, TRACY, CA 95376-3080
(209) 832-2095
(209) 832-7828
Mailing address
1530 BESSIE AVE, STE 105, TRACY, CA 95376-3080
(209) 467-6866
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A76322
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A763220
—
CA
Enumeration date
11/02/2006
Last updated
06/06/2016
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