Individual
MARY KATHLEEN MCCLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 MEDICAL PLAZA, #365,420,530,120, LOS ANGELES, CA 90095-5655
(310) 825-6301
(310) 794-9718
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5655
(310) 825-6301
(310) 794-9718
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN369858
CA
163WC0200X
Critical Care Medicine Registered Nurse
RN369858
CA
207RC0000X
Cardiovascular Disease Physician
Primary
NP8445
CA
363L00000X
Nurse Practitioner
NP8445
CA
363LA2100X
Acute Care Nurse Practitioner
NP8445
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN3698580
—
CA
Enumeration date
07/19/2006
Last updated
01/08/2013
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