Provider Demographics
NPI:1316372642
Name:MCDOLE, MARYCATHERINE CHERI (MA)
Entity Type:Individual
Prefix:
First Name:MARYCATHERINE
Middle Name:CHERI
Last Name:MCDOLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:
Other - Last Name:MCDOLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1125 W. 6TH ST.
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017
Mailing Address - Country:US
Mailing Address - Phone:310-927-6608
Mailing Address - Fax:
Practice Address - Street 1:1125 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1833
Practice Address - Country:US
Practice Address - Phone:213-202-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program