Provider Demographics
NPI:1174818280
Name:MCELROY, MEGAN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MCELROY
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 SANTA MONICA BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4496
Mailing Address - Country:US
Mailing Address - Phone:909-962-1260
Mailing Address - Fax:
Practice Address - Street 1:8550 SANTA MONICA BLVD FL 2
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4496
Practice Address - Country:US
Practice Address - Phone:909-962-1260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
TXPA07389363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical