1760652234 NPI number — DR. MEGAN DUFFY MCNALLY D.O.

Table of content: MATTHEW REED RN (NPI 1316767528)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760652234 NPI number — DR. MEGAN DUFFY MCNALLY D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCNALLY
Provider First Name:
MEGAN
Provider Middle Name:
DUFFY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUFFY
Provider Other First Name:
MAUREEN
Provider Other Middle Name:
MEGAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1760652234
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2374 E PACIFICA PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANCHO DOMINGUEZ
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90220-6214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-225-3244
Provider Business Mailing Address Fax Number:
310-698-7054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5005 S 40TH ST
Provider Second Line Business Practice Location Address:
SUITE 1200
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85040-2969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-453-7130
Provider Business Practice Location Address Fax Number:
310-698-7054
Provider Enumeration Date:
03/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , with the licence number:  4816 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 47978 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 7405355-1204 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: R874 . This is a "TRAINING PERMIT" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 4816 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 680 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 7888 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 8345A . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".
  • Identifier: DO1506 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: O-0571 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com