Organization Active NPI

McLean Medical Clinic Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Van Nuys, CA
National Provider Identifier
1588479216
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
MCLEAN MEDICAL CLINIC INC
Practice address
6817 1/2 Kester Ave
Van Nuys, CA 91405-3716
Phone
(747) 755-2455
Fax
(747) 755-2452
NPI assigned
Feb 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Michael K McLean, MDNPI 1831276468
Title
President/Owner
Phone
(747) 755-2455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

6817 1/2 Kester Ave
Van Nuys, CA 91405-3716

Mailing address

6817 1/2 Kester Ave
Van Nuys, CA 91405-3716
Phone (747) 755-2455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250324000267 CA Part B Supplier - Clinic/Group Practice 8628590312 Receives reassigned benefits from 2 practitioners
Practice locations: Van Nuys, CA

National Provider Directory

National Provider Directory

Locations

6817 Kester Ave
Van Nuys, CA 91405
Phone (747) 755-2455

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1588479216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 1/2 KESTER AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053716",
            "telephone_number": "747-755-2455",
            "fax_number": "747-755-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 1/2 KESTER AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053716",
            "telephone_number": "747-755-2455",
            "fax_number": "747-755-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEAN MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "MCLEAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "747-755-2455",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.