Provider Demographics
NPI:1417275058
Name:MCNAB, ANDREA BETH (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:BETH
Last Name:MCNAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 VINELAND AVE APT 619
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-7018
Mailing Address - Country:US
Mailing Address - Phone:989-245-3346
Mailing Address - Fax:
Practice Address - Street 1:17877 VON KARMAN AVE STE 350
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5236
Practice Address - Country:US
Practice Address - Phone:949-919-6557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA156255208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery