Healthcare Provider Details

I. General information

NPI: 1841121779
Provider Name (Legal Business Name): ALLAN GEORGE MACDONALD OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 DE LONGPRE AVE APT 405
WEST HOLLYWOOD CA
90069-2638
US

IV. Provider business mailing address

8400 DE LONGPRE AVE APT 405
WEST HOLLYWOOD CA
90069-2638
US

V. Phone/Fax

Practice location:
  • Phone: 323-620-1449
  • Fax:
Mailing address:
  • Phone: 323-620-1449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number2927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: