MEDICARE: DR. ASHLEIGH MACLEAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	01087937A	IN
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207P00000X	Emergency Medicine Physician	A180531	CA

General Provider Information

NPI Number	:	1760040240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEIGH MACLEAN MD

Provider Business Mailing Address
First Line	:	140 W CASTELLANO DR UNIT 312
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-6302
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 W CASTELLANO DR UNIT 312
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-6302
Country	:	US
Telephone Number	:	916-765-8524
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	09/13/2022

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