MEDICARE: MR. DAVID A MCCALL RCP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2278H0200X	Home Health Certified Respiratory Therapist	00018764	CA

General Provider Information

NPI Number	:	1558364000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID A MCCALL RCP

Provider Business Mailing Address
First Line	:	8219 REDLANDS ST
Second Line	:	APT 12
City	:	PLAYA DEL REY
State	:	CA
Zip	:	90293-8195
Country	:	US
Telephone Number	:	310-614-0788
Fax Number	:	310-823-3925

Provider Business Practice Location Address
First Line	:	8219 REDLANDS ST
Second Line	:	APT 12
City	:	PLAYA DEL REY
State	:	CA
Zip	:	90293-8195
Country	:	US
Telephone Number	:	310-614-0788
Fax Number	:	310-823-3925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2005
Last Update Date	:	07/08/2007

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