Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A86738 | CA |
NPI | 1023164415 |
---|---|
Provider Name | Dr. Angus R Macdonald |
First Address | Los Angeles, CA 90004-3714 |
Second Address | Torrance, CA 90505-6658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 08/07/2007 |