Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | A78565 | CA |
NPI | 1265658959 |
---|---|
Provider Name | Dr. Amy Catherine Mcclune |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A785650 | (05) | CA |