Individual
LOUIS J MCNABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 LAGUNA RD, SUITE 2, FULLERTON, CA 92835-2523
(714) 446-7454
(714) 879-1049
Mailing address
220 LAGUNA RD, SUITE 2, FULLERTON, CA 92835-2523
(714) 446-7454
(714) 879-1049
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G36837
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
G36837
CA
207RP1001X
Pulmonary Disease Physician
Primary
G36837
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290003319
RAILROAD MEDICARE
CA
01
—
G36837
STATE LICENSE
CA
01
—
GR0014371
MEDI-CAL PROV
CA
01
—
ZZZ97067Z
BLUE SHIELD
CA
Enumeration date
11/02/2006
Last updated
09/23/2011
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