Provider Demographics
NPI:1568633246
Name:THE MCDONALD CLINIC INC
Entity Type:Organization
Organization Name:THE MCDONALD CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-303-3337
Mailing Address - Street 1:31493 RANCHO PUEBLO RD.
Mailing Address - Street 2:SUITE #107
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4832
Mailing Address - Country:US
Mailing Address - Phone:951-303-3337
Mailing Address - Fax:951-303-2810
Practice Address - Street 1:31493 RANCHO PUEBLO RD.
Practice Address - Street 2:SUITE #107
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4832
Practice Address - Country:US
Practice Address - Phone:951-303-3337
Practice Address - Fax:951-303-2810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty