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NPI Code Detail

MEDICARE: DR. KRISTINE MARIE MCGILL PHARM.D.

MEDICARE: DR. KRISTINE MARIE MCGILL PHARM.D.
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
1183500000XPharmacist56214CA

General Provider Information

NPI Number : 1891857769
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTINE MARIE MCGILL PHARM.D.
Provider Business Mailing Address
First Line : 7703 HANNUM AVE
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6164
Country : US
Telephone Number : 310-391-7930
Fax Number :
Provider Business Practice Location Address
First Line : 5971 VENICE BLVD
Second Line : BASEMENT AMB CARE PHARMACY CARE MANAGEMENT DEPT.
City : LOS ANGELES
State : CA
Zip : 90034-1713
Country : US
Telephone Number : 323-857-2062
Fax Number : 323-857-3923
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 07/08/2007

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