MEDICARE: DEBON MCGILL PSYD

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1922159813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBON MCGILL PSYD

Provider Business Mailing Address
First Line	:	501 W BROADWAY STE 1540
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-3770
Country	:	US
Telephone Number	:	619-292-8072
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 W BROADWAY STE 1540
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-3770
Country	:	US
Telephone Number	:	619-292-8072
Fax Number	:

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	07/28/2025

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