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General NPI Number Information
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NPI Number | 1255053047
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Entity Type | Individual
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Provider Name | ELIZABETH MCNEIL FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 22386 CAMINITO MADERA
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1638
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Country | US
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Telephone | 714-225-8639
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Fax |
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Provider Business Mailing Address
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Address Line | 8201 NEWMAN AVE STE 301
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-7043
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Country | US
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Telephone | 714-847-6900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 95022617
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License Number State | CA
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