Healthcare Provider Details

I. General information

NPI: 1437349669
Provider Name (Legal Business Name): STEVEN BRYAN MACLEAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 21
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1630 OCEAN AVE
SEAL BEACH CA
90740-6549
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-3501
  • Fax:
Mailing address:
  • Phone: 206-940-2458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: