Provider Demographics
NPI:1114982675
Name:MCELVEEN, CATHY LYNN (DO)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNN
Last Name:MCELVEEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 ROCKLAND PL
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1269
Mailing Address - Country:US
Mailing Address - Phone:818-541-9391
Mailing Address - Fax:
Practice Address - Street 1:1855 N FAIR OAKS AVE STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1620
Practice Address - Country:US
Practice Address - Phone:626-398-6300
Practice Address - Fax:626-398-5948
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10140208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1114982675Medicaid