Provider Demographics
NPI:1659412229
Name:MCKENZIE-ALBIN, CLAUDETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDETTE
Middle Name:
Last Name:MCKENZIE-ALBIN
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 1:800 FAIRMOUNT AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3152
Mailing Address - Country:US
Mailing Address - Phone:626-584-6900
Mailing Address - Fax:
Practice Address - Street 1:800 FAIRMOUNT AVE STE 210
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3152
Practice Address - Country:US
Practice Address - Phone:626-584-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41155207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC41155Medicare ID - Type Unspecified