Individual
HEATHER R MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1510 SAN PABLO ST, SUITE 514, LOS ANGELES, CA 90033-5324
(323) 865-3000
(323) 442-6798
Mailing address
1510 SAN PABLO ST, SUITE 514, LOS ANGELES, CA 90033-5324
(323) 865-3000
(323) 442-6798
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A75177
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A751770
BLUE SHIELD PIN
CA
05
—
00A751770
—
CA
01
—
00A751770C29
CAL OPTIMA
CA
Enumeration date
08/30/2006
Last updated
11/27/2013
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