Provider Demographics
NPI:1346408663
Name:MAUGERI, RONALD CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CHARLES
Last Name:MAUGERI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6247
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90264-6247
Mailing Address - Country:US
Mailing Address - Phone:310-456-1972
Mailing Address - Fax:310-456-1974
Practice Address - Street 1:23440 CIVIC CENTER WAY
Practice Address - Street 2:SUITE 204
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-4854
Practice Address - Country:US
Practice Address - Phone:310-456-1972
Practice Address - Fax:310-457-5974
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31307111NN1001X, 111NP0017X, 111NR0400X, 111NS0005X, 111NX0800X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0800XChiropractic ProvidersChiropractorOrthopedic