Organization
JOHN K MCKISSOCK MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN K MCKISSOCK M.D. (PROPRIETOR)
(310) 257-9425
Entity
Organization
Contact information
Practice address
3440 LOMITA BLVD, 150, TORRANCE, CA 90505-4801
(310) 257-9425
(310) 530-2146
Mailing address
3440 LOMITA BLVD, 150, TORRANCE, CA 90505-4801
(310) 257-9425
(310) 530-2146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G84015
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G840150
—
CA
Enumeration date
12/28/2007
Last updated
12/28/2007
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