Organization
JOHN P MCKENZIE III M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PAUL MCKENZIE III M.D. (PHYSICIAN)
(818) 502-9420
Entity
Organization
Contact information
Practice address
660 W BROADWAY, GLENDALE, CA 91204-1008
(818) 502-9420
(818) 243-9605
Mailing address
1510 S CENTRAL AVE, SUITE 150, GLENDALE, CA 91204-2500
(818) 247-0346
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
G71752
CA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
G71752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G717520
—
CA
Enumeration date
06/19/2006
Last updated
06/30/2009
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