Mark McDonald, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A112267 Issued in CA

Practice address

11500 W Olympic Blvd
Suite 426
Los Angeles, CA 90064-1524

Phone

(310) 954-9565

Fax

(310) 359-0467

NPI assigned

Oct 22, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1114116506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD",
            "address_2": "SUITE 426",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641524",
            "telephone_number": "310-954-9565",
            "fax_number": "310-359-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD",
            "address_2": "SUITE 426",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641524",
            "telephone_number": "310-954-9565",
            "fax_number": "310-359-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A112267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Ross McDonald
• Jenea McDonald
• Jessica McDonald, PSY.D.
• John David McDonald II, DPT
• Kyla McDonald
• Melinda Eva McDonald
• Nancy McDonald, MFTI
• Nicole Marie McDonald, PHD
• Sara McDonald
• Scott McDonald

• Child & Adolescent Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.