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MACHUCA MEDICAL LLC NPI 1053861369


NPI Information

NPI: 1053861369
Provider Name: MACHUCA MEDICAL LLC

Doing Business As: MACHUCA MEDICAL

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 36D2123219

Address:
7371 BRANDT PIKE STE D
HUBER HEIGHTS, OH
ZIP 45424
Phone: (937) 795-1101
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MACHUCA MEDICAL LLC is a family medicine in Huber Heights, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MACHUCA MEDICAL LLC NPI is 1053861369. The provider is registered as an organization entity type.
The provider Is Doing Business As Machuca Medical.

The provider's business location address is:

7371 BRANDT PIKE STE D
HUBER HEIGHTS, OH
ZIP 45424-276
Phone: (937) 795-1101
Fax: (937) 795-1120

The provider's authorized official is Jennifer Lynn Machuca .
The authorized official title is Md/ Solo Physician and has the following contact phone number (937) 795-1101.

The CLIA number assigned to this NPI record is 36D2123219 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/11/2016 and was last updated on 2/24/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareNo
2207Q00000XFamily Medicine92123OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12893301MEDICAIDOHIO
21669694246OTHERINDIVIDUAL NPI
31053861369OTHERGROUP NPI
4MA4253051OTHERLEGACY
5H598960OTHERPTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.