Individual
ELLEN MACKENZIE MCCLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4650 W SUNSET BLVD # 40, LOS ANGELES, CA 90027-6062
(323) 361-6471
Mailing address
4650 W SUNSET BLVD # 40, LOS ANGELES, CA 90027-6062
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1075515
REGISTERED DIETITIAN
—
Enumeration date
06/29/2017
Last updated
06/29/2017
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