Healthcare Provider Details

I. General information

NPI: 1578587051
Provider Name (Legal Business Name): DUNCAN Q MCBRIDE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 16TH STREET SUITE 220
SANTA MONICA CA
90095
US

IV. Provider business mailing address

PO BOX 512025 DEPT
LOS ANGELES CA
90051
US

V. Phone/Fax

Practice location:
  • Phone: 310-319-3475
  • Fax: 310-319-4575
Mailing address:
  • Phone: 310-319-3475
  • Fax: 310-319-4575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DUNCAN QUINCY MCBRIDE
Title or Position: CEO
Credential: MD
Phone: 310-544-7000