Individual
DR. ELLYN GRACE MCINTOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3700 W 190TH ST, TORRANCE, CA 90504-5733
(310) 212-4705
(310) 212-2941
Mailing address
3700 W 190TH ST, TORRANCE, CA 90504-5733
(310) 212-4705
(310) 212-2941
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
10280
MT
2083X0100X
Occupational Medicine Physician
27726
OK
2083X0100X
Occupational Medicine Physician
64689
GA
2083X0100X
Occupational Medicine Physician
Primary
G55377
CA
2083X0100X
Occupational Medicine Physician
ME107354
FL
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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