Healthcare Provider Details

I. General information

NPI: 1306897897
Provider Name (Legal Business Name): CAMELA ANN MCGRATH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5525 GROSSMONT CENTER DR
LA MESA CA
91942-3009
US

IV. Provider business mailing address

2609 W CANYON AVE APT 311
SAN DIEGO CA
92123-4730
US

V. Phone/Fax

Practice location:
  • Phone: 858-499-2702
  • Fax:
Mailing address:
  • Phone: 224-627-1299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG80722
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: