Healthcare Provider Details

I. General information

NPI: 1336207745
Provider Name (Legal Business Name): JOHN D MCCARTHY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 02/15/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15141 WHITTIER BLVD STE 360
WHITTIER CA
90603-2184
US

IV. Provider business mailing address

PO BOX 11540
WHITTIER CA
90603-0540
US

V. Phone/Fax

Practice location:
  • Phone: 626-912-5767
  • Fax: 562-360-1443
Mailing address:
  • Phone: 562-696-9265
  • Fax: 877-887-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN D MCCARTHY
Title or Position: PHYSICIAN
Credential: MD
Phone: 626-912-5767