Genevieve a. Mac Donald M.D. Inc.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

G16852 Issued in CA

Legal business name

GENEVIEVE A. MAC DONALD M.D. INC.

Practice address

15477 Ventura Blvd Ste 100
Sherman Oaks, CA 91403-3046

Phone

(818) 906-2141

Fax

(800) 814-8755

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Genevieve A Mac Donald, M.D.

Title

President

Phone

(818) 906-2141

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1740471259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15477 VENTURA BLVD STE 100",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033046",
            "telephone_number": "818-906-2141",
            "fax_number": "800-814-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15477 VENTURA BLVD STE 100",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033046",
            "telephone_number": "818-906-2141",
            "fax_number": "800-814-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEVIEVE A. MAC DONALD M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "MAC DONALD",
        "authorized_official_first_name": "GENEVIEVE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-906-2141",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G16852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1780740993",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G16852",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "G16852",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.