Individual
GREGORY SCOTT MACDONELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15195 NATIONAL AVE, #100, LOS GATOS, CA 95032
(408) 356-0454
Mailing address
718 UNIVERSITY AVE, #211, LOS GATOS, CA 95032
(408) 354-2114
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G59930
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G599300
—
CA
Enumeration date
07/12/2006
Last updated
01/05/2011
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