Provider Demographics
NPI:1215023767
Name:MACLEAY, LACHLAN JR (MD)
Entity Type:Individual
Prefix:
First Name:LACHLAN
Middle Name:
Last Name:MACLEAY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 744127
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-4127
Mailing Address - Country:US
Mailing Address - Phone:760-739-3039
Mailing Address - Fax:972-498-9702
Practice Address - Street 1:555 EAST VALLEY PARKWAY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025
Practice Address - Country:US
Practice Address - Phone:760-739-3030
Practice Address - Fax:760-739-2604
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43788207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A437880Medicaid
CAWA43788BMedicare PIN
CA220014956Medicare PIN
CAWA43788AMedicare PIN
CAE57361Medicare UPIN