Healthcare Provider Details

I. General information

NPI: 1851991012
Provider Name (Legal Business Name): JOHN MCGADY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E SPRING ST STE 11
LONG BEACH CA
90806-1625
US

IV. Provider business mailing address

17025 WILKIE AVE
TORRANCE CA
90504-2823
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-7702
  • Fax: 562-933-7705
Mailing address:
  • Phone: 310-489-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number65184
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: