Individual
JOHN J MCDERMOTT III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 E FOOTHILL BLVD, CLAREMONT, CA 91711-3511
(909) 624-8077
(909) 624-1467
Mailing address
655 E FOOTHILL BLVD, CLAREMONT, CA 91711-3511
(909) 624-8077
(909) 624-1467
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A62498
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A624980
—
CA
01
—
A62498
STATE LIC #
CA
01
—
E CROSS PIN
BLUE CROSS PIN
CA
Enumeration date
09/27/2006
Last updated
08/15/2012
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