Organization
GENEVIEVE A. MAC DONALD M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIEVE A MAC DONALD M.D. (PRESIDENT)
(818) 906-2141
Entity
Organization
Contact information
Practice address
15477 VENTURA BLVD STE 100, SHERMAN OAKS, CA 91403-3046
(818) 906-2141
(800) 814-8755
Mailing address
15477 VENTURA BLVD STE 100, SHERMAN OAKS, CA 91403-3046
(818) 906-2141
(800) 814-8755
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
G16852
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G16852
—
CA
01
—
1780740993
NPI TYPE 1
CA
01
—
G16852
LICENSE NUMBER
CA
Enumeration date
08/08/2007
Last updated
05/02/2011
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