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Individual

MR. STUART J MACDONELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
204 GREEN VALLEY RD, FREEDOM, CA 95019-3135
(831) 728-2005
(831) 728-3310
Mailing address
6399 SAN IGNACIO AVE STE 120, SAN JOSE, CA 95119-1215
(408) 369-5620

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
103850
NC
363AM0700X
Medical Physician Assistant
Primary
54521
CA

Other

Enumeration date
05/02/2006
Last updated
03/19/2024
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