Provider Demographics
NPI:1598330227
Name:MCNAUGHTON, MADISON LOREN
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:LOREN
Last Name:MCNAUGHTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8482 E FROSTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-1208
Mailing Address - Country:US
Mailing Address - Phone:714-321-0707
Mailing Address - Fax:888-602-0251
Practice Address - Street 1:8482 E FROSTWOOD ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-1208
Practice Address - Country:US
Practice Address - Phone:714-321-0707
Practice Address - Fax:888-602-0251
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies