MEDICARE: MISS MEGAN AILEEN DOYLE M.S.W.

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	1041C0700X	Clinical Social Worker	22631	CA

General Provider Information

NPI Number	:	1588800163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MEGAN AILEEN DOYLE M.S.W.

Provider Business Mailing Address
First Line	:	8600 W OLYMPIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1906
Country	:	US
Telephone Number	:	714-883-7618
Fax Number	:

Provider Business Practice Location Address
First Line	:	8600 W OLYMPIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1906
Country	:	US
Telephone Number	:	714-883-7618
Fax Number	:

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

Provider Enumeration Date	:	01/02/2009
Last Update Date	:	01/02/2009

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