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General NPI Number Information
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NPI Number | 1821423070
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Entity Type | Organization
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Legal Business Name | GENEVIEVE A. MACDONALD, M.D., INC.
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 11/23/2013
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Provider Practice Location Address
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Address Line | 16200 VENTURA BLVD SUITE 309
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City | ENCINO
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State | CA
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Zip | 91436-2205
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Country | US
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Telephone | 818-990-0595
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Fax | 818-990-0553
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Provider Business Mailing Address
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Address Line | 16200 VENTURA BLVD SUITE 309
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City | ENCINO
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State | CA
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Zip | 91436-2205
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Country | US
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Telephone | 818-990-0595
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Fax | 818-990-0553
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Authorized Official
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Title or Position | CEO
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Name | GENEVIEVE A MACDONALD
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Credential | M.D.
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Telephone | 818-990-0595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | G16852
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License Number State | CA
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