Individual
DR. JAKLYN RAE MCCLENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1111 W LA PALMA AVE, AMMC - DEPT. OF PATHOLOGY, ANAHEIM, CA 92801-2804
(714) 999-6075
(714) 999-3822
Mailing address
1111 W LA PALMA AVE, DEPT. OF PATHOLOGY, ANAHEIM, CA 92801-2804
(714) 999-6075
(714) 999-3822
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
G50440
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G50440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G504400
—
CA
Enumeration date
04/07/2006
Last updated
10/04/2007
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