Healthcare Provider Details

I. General information

NPI: 1255352944
Provider Name (Legal Business Name): PATRICIA A MCNEILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS PATRICIA A HYDE

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 W GIBSON RD
WOODLAND CA
95695
US

IV. Provider business mailing address

632 W GIBSON RD
WOODLAND CA
95695
US

V. Phone/Fax

Practice location:
  • Phone: 530-666-1631
  • Fax:
Mailing address:
  • Phone: 530-666-1631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG55974
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: