Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G62774 | CA |
NPI | 1003877564 |
---|---|
Provider Name | Dr. Laurie Colleen Mccall |
First Address | Ventura, CA 93003-6555 |
Second Address | Ventura, CA 93003-6555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G627740 | (05) | CA |
E61478 | (02) | CA |