Individual
TRAVERS J MCLOUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 S HAM LN, LODI, CA 95242-3512
(209) 365-1761
(209) 333-3673
Mailing address
311 S HAM LN, LODI, CA 95242-3512
(209) 368-5262
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A92339
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A923390
—
CA
01
—
P00441161
RAILROAD MEDICARE
CA
Enumeration date
06/13/2006
Last updated
07/07/2015
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