Provider Demographics
NPI:1467724252
Name:MCMAHON, LAUREN A (DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4023 SUNSET DR
Mailing Address - Street 2:APT 11
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-1565
Mailing Address - Country:US
Mailing Address - Phone:973-907-3024
Mailing Address - Fax:
Practice Address - Street 1:12411 SLAUSON AVE
Practice Address - Street 2:UNIT H
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2835
Practice Address - Country:US
Practice Address - Phone:562-693-5449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38289225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist