Healthcare Provider Details

I. General information

NPI: 1780907949
Provider Name (Legal Business Name): NANCY MCLAUGHLIN MD, PHD, FRCSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SANTA MONICA BLVD
SANTA MONICA CA
90404-2302
US

IV. Provider business mailing address

2200 SANTA MONICA BLVD
SANTA MONICA CA
90404-2302
US

V. Phone/Fax

Practice location:
  • Phone: 310-582-7450
  • Fax:
Mailing address:
  • Phone: 310-582-7450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA111274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: