MEDICARE: ALBERT A. MCCLAIN, JR., M.D., INC.

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	207Y00000X	Otolaryngology Physician	G71625	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861501751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERT A. MCCLAIN, JR., M.D., INC.

Provider Business Mailing Address
First Line	:	655 EUCLID AVE STE 401
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2978
Country	:	US
Telephone Number	:	619-267-8440
Fax Number	:	619-267-8032

Provider Business Practice Location Address
First Line	:	655 EUCLID AVE STE 401
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2978
Country	:	US
Telephone Number	:	619-267-8440
Fax Number	:	619-267-8032

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALBERT A. MCCLAIN JR.
Credential	:	M. D.
Telephone Number	:	619-267-8440

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	01/06/2015

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