Healthcare Provider Details

I. General information

NPI: 1326734773
Provider Name (Legal Business Name): MAEVE MCDONNELL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11230 GARVEY AVE
EL MONTE CA
91733-2475
US

IV. Provider business mailing address

11230 GARVEY AVE
EL MONTE CA
91733-2475
US

V. Phone/Fax

Practice location:
  • Phone: 626-443-8226
  • Fax:
Mailing address:
  • Phone: 626-443-8226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35559-TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: