Healthcare Provider Details

I. General information

NPI: 1801006473
Provider Name (Legal Business Name): MARY MCFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 S. GRAND AVE 116
LOS ANGELES CA
90007
US

IV. Provider business mailing address

1910 W SUNSET BLVD. SUITE 650
LOS ANGELES CA
90026
US

V. Phone/Fax

Practice location:
  • Phone: 213-744-3643
  • Fax: 213-744-3594
Mailing address:
  • Phone: 213-353-1111
  • Fax: 213-353-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number374915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: