Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A53976 | CA |
NPI | 1427196625 |
---|---|
Provider Name | Michael R. Macdonald |
First Address | San Francisco, CA 94102 |
Second Address | San Francisco, CA 94102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 09/04/2018 |