# JON G MCLENNAN, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114199262
- **Authorized official:** JON G MCLENNAN M.D. (OWNER)
- **Authorized official phone:** (760) 771-4900

## Contact information

- **Practice address:** 79440 CORPORATE CENTER DR STE 118, LA QUINTA, CA 92253-7244
- **Practice address phone:** (760) 771-4900
- **Practice address fax:** (760) 771-4906
- **Mailing address:** PO BOX 2129, RANCHO MIRAGE, CA 92270-1055
- **Mailing address phone:** (760) 771-4900
- **Mailing address fax:** (760) 771-4906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G30682 | CA | Yes |

## Other

- **Enumeration date:** 03/28/2008
- **Last updated:** 11/28/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G306820 | — | CA |