Provider Demographics
NPI:1477811693
Name:MCGAHAN, MICHELE CHRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:CHRISTINA
Last Name:MCGAHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:CHRISTINA
Other - Last Name:ROCHELLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8745 AERO DR STE 200
Mailing Address - Street 2:P.O. BOX 23540
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1774
Mailing Address - Country:US
Mailing Address - Phone:760-940-4055
Mailing Address - Fax:760-940-4084
Practice Address - Street 1:8745 AERO DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1774
Practice Address - Country:US
Practice Address - Phone:760-940-4055
Practice Address - Fax:760-940-4084
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD602647892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology