Active NPI
Michael D. McGavic DPM, a Professional Corporation
- Podiatrist
- Norwalk, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E4048
- Legal business name
- MICHAEL D. MCGAVIC DPM, A PROFESSIONAL CORPORATION
- Practice address
- 13132 Studebaker Rd
Suite 2
Norwalk, CA 90650-2557 - Phone
- (562) 651-1111
- Fax
- (562) 651-1131
- NPI assigned
- May 11, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael Darin McGavic
- Title
- Doctor/President
- Phone
- (562) 651-1111
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E4048 | CA | Primary |
Addresses
Primary practice location
13132 Studebaker Rd
Suite 2
Norwalk, CA 90650-2557
Mailing address
13132 Studebaker Rd
Suite 2
Norwalk, CA 90650-2557
Phone (562) 651-1111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E40480 | Other | CA | MEDICARE ID |
Other names 1
- Michael D. McGavic, A Professional Corporation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Podiatrist
- Norwalk, CA
- NPI 1750557575
O20100127000128
National Provider Directory
National Provider Directory- Tax ID family
- Michael D McGavic Apc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Podiatrist
- Norwalk, CA
- NPI 1750557575
Locations
1755 W Hammer Ln
Stockton, CA 95209
Phone (209) 444-8910
1755 W Hammer Ln
#S7B
Stockton, CA 95209
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Norwalk, CA
- NPI 1033137427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273536000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732060800000",
"number": "1144548439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13132 STUDEBAKER RD",
"address_2": "SUITE 2",
"city": "NORWALK",
"state": "CA",
"postal_code": "906502557",
"telephone_number": "562-651-1111",
"fax_number": "562-651-1131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13132 STUDEBAKER RD",
"address_2": "SUITE 2",
"city": "NORWALK",
"state": "CA",
"postal_code": "906502557",
"telephone_number": "562-651-1111",
"fax_number": "562-651-1131"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHAEL D. MCGAVIC DPM, A PROFESSIONAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2010-05-11",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A",
"authorized_official_last_name": "MCGAVIC",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "DARIN",
"authorized_official_title_or_position": "DOCTOR/PRESIDENT",
"authorized_official_telephone_number": "562-651-1111",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "CA",
"license": "E4048",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "000E40480",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Michael D. McGavic, A Professional Corporation",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Michael D. McGavic, A Professional Corporation",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.