Individual
TARA ALEXANDRA MCCANNEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 STEIN PLAZA, RM 1-340, LOS ANGELES, CA 90095-7065
(310) 825-5000
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 825-5000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A87675
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A876750
—
CA
Enumeration date
07/24/2006
Last updated
05/07/2013
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