Individual
DR. NEIL E DOHERTY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
552 W FOOTHILL BLVD STE 201, GLENDORA, CA 91741-2470
(626) 915-4700
(626) 214-7815
Mailing address
235 E BADILLO ST, COVINA, CA 91723-2116
(626) 915-4700
(626) 857-7340
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G51688
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G516880
—
CA
01
—
G51688
MEDICAL BOARD OF CALIFORNIA
CA
01
—
WG51688A
MEDICARE PPIN
—
Enumeration date
03/17/2006
Last updated
11/15/2023
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