Provider Demographics
NPI:1386732915
Name:HEILBRON, MAURICIO J JR (MD)
Entity type:Individual
Prefix:
First Name:MAURICIO
Middle Name:J
Last Name:HEILBRON
Suffix:JR
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1045 ATLANTIC AVE
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3408
Mailing Address - Country:US
Mailing Address - Phone:562-435-5511
Mailing Address - Fax:562-435-7503
Practice Address - Street 1:1045 ATLANTIC AVE
Practice Address - Street 2:SUITE 1002
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3408
Practice Address - Country:US
Practice Address - Phone:562-435-5511
Practice Address - Fax:562-435-7503
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAGO822392086S0129X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG71669Medicare UPIN