Provider Demographics
NPI:1326387184
Name:RAND MCCLAIN DO INC
Entity Type:Organization
Organization Name:RAND MCCLAIN DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINITRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENSPAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-951-3531
Mailing Address - Street 1:500 S SEPULVEDA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6945
Mailing Address - Country:US
Mailing Address - Phone:310-951-3531
Mailing Address - Fax:310-949-3911
Practice Address - Street 1:500 S SEPULVEDA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6945
Practice Address - Country:US
Practice Address - Phone:310-951-3531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10511261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy