Individual
DR. JEANINE AURAL MCNEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(909) 486-4000
Mailing address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(909) 486-4000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35086535
OH
2085R0202X
Diagnostic Radiology Physician
Primary
G53060
CA
2085U0001X
Diagnostic Ultrasound Physician
35086535
OH
2085U0001X
Diagnostic Ultrasound Physician
G53060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000500893
ANTHEM
OH
05
—
00G530600
—
CA
05
—
2708958
—
OH
01
—
P00383065
RAILROAD MEDICARE
OH
Enumeration date
12/02/2005
Last updated
09/20/2021
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