Provider Demographics
NPI:1376622324
Name:DONELLE LAUGHLIN, M.D., INC.
Entity Type:Organization
Organization Name:DONELLE LAUGHLIN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONELLE
Authorized Official - Middle Name:AILEEN
Authorized Official - Last Name:LAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-649-0175
Mailing Address - Street 1:PO BOX 1711
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-1711
Mailing Address - Country:US
Mailing Address - Phone:831-649-0175
Mailing Address - Fax:831-646-0220
Practice Address - Street 1:889 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4463
Practice Address - Country:US
Practice Address - Phone:831-649-0175
Practice Address - Fax:831-646-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65672174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27236ZMedicare ID - Type Unspecified
CAH20791Medicare UPIN