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General NPI Number Information
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NPI Number | 1184446361
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Entity Type | Organization
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Legal Business Name | MCLEAN MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 7535 LAUREL CANYON BLVD
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City | N. HOLLYWOOD
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State | CA
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Zip | 91605
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Country | US
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Telephone | 818-850-5088
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Fax |
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Provider Business Mailing Address
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Address Line | 7535 LAUREL CANYON BLVD
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City | N HOLLYWOOD
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State | CA
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Zip | 91605
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Country | US
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Telephone | 818-850-5088
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR OWNER
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Name | MICHAEL MCLEAN
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Credential | MD
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Telephone | 818-850-5088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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