Individual
IAN TAYLOR MACQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1304 15TH ST STE 105, SANTA MONICA, CA 90404-1810
(310) 319-4080
(310) 394-5215
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A130834
CA
Other
Enumeration date
04/13/2012
Last updated
10/11/2019
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