Organization
JON G MCLENNAN, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON G MCLENNAN M.D. (OWNER)
(760) 771-4900
Entity
Organization
Contact information
Practice address
79440 CORPORATE CENTER DR STE 118, LA QUINTA, CA 92253-7244
(760) 771-4900
(760) 771-4906
Mailing address
PO BOX 2129, RANCHO MIRAGE, CA 92270-1055
(760) 771-4900
(760) 771-4906
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G30682
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G306820
—
CA
Enumeration date
03/28/2008
Last updated
11/28/2016
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