Active NPI
Richard Henry Macklin, M.D.
- Anesthesiology Physician
- Bell, CA
National Provider Identifier
1619074044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G30633
- Practice address
- 5101 Florence Ave Ste 5
Bell, CA 90201-3801 - Phone
- (323) 562-6931
- Fax
- (323) 562-6798
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G30633 | CA | Primary |
Addresses
Primary practice location
5101 Florence Ave Ste 5
Bell, CA 90201-3801
Mailing address
5101 E Florence Ave
#5
Bell, CA 90201
Phone (323) 562-6931
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G306330 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G30633 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roswell Clinic Corp | Past | Accepting new patients | |
| Mary S. Romo MD, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Bell, CA
- NPI 1780998328
-
- Family Medicine Physician
- Roswell, NM
- NPI 1649267618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431561600000",
"number": "1619074044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5101 E FLORENCE AVE",
"address_2": "#5",
"city": "BELL",
"state": "CA",
"postal_code": "90201",
"telephone_number": "323-562-6931",
"fax_number": "323-562-6798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5101 FLORENCE AVE STE 5",
"city": "BELL",
"state": "CA",
"postal_code": "902013801",
"telephone_number": "323-562-6931",
"fax_number": "323-562-6798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKLIN",
"first_name": "RICHARD",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2015-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G30633",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G306330",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.