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Individual

TENNYSON SCOTT MACDONALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2975 SYCAMORE DR, SIMI VALLEY, CA 93065-1201
(805) 955-6000
Mailing address
2082 NEWBURY RD STE 14, NEWBURY PARK, CA 91320-3368
(805) 498-4344

Taxonomy

Speciality
Code
Description
License number
State
2278P3900X
Neonatal/Pediatric Certified Respiratory Therapist
Primary
9454
CA

Other

Enumeration date
01/07/2011
Last updated
01/07/2011
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