NPI Code Detail JSON Logo

1558357913 NPI number — ERIC CLYDE MCDONALD M.D.

NPI Number: 1558357913
Health Care Provider/Practitioner: ERIC CLYDE MCDONALD M.D.

Information about “1558357913” NPI (ERIC CLYDE MCDONALD M.D.) exists in 1558357913 in HTML format HTML  |  1558357913 in plain Text format TXT  |  1558357913 in PDF (Portable Document Format) PDF  |  1558357913 in an XML format XML  formats.

NPI Number : 1558357913 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558357913",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "X",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCDONALD",
    "FirstName": "ERIC",
    "MiddleName": "CLYDE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4143 SUNSET RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN DIEGO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92103-1144",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "619-297-7088",
    "MailingAddressFaxNumber": "619-297-6638",
    "FirstLinePracticeLocationAddress": "34520 BOB WILSON DR",
    "SecondLinePracticeLocationAddress": "NAVAL MEDICAL CENTER SAN DIEGO",
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92134-2098",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "619-532-8275",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/21/2005",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207P00000X",
        "TaxonomyName": "Emergency Medicine Physician",
        "LicenseNumber": "G67352",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.