Provider Demographics
NPI:1073587994
Name:MCNEIL, DAVID L (ATC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 MESA DR APT 11
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-4682
Mailing Address - Country:US
Mailing Address - Phone:562-309-3011
Mailing Address - Fax:
Practice Address - Street 1:2650 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5599
Practice Address - Country:US
Practice Address - Phone:714-424-7863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0800020802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer