Provider Demographics
NPI:1679650923
Name:MCCARTHY, JOHN D
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11540
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-0540
Mailing Address - Country:US
Mailing Address - Phone:562-696-9265
Mailing Address - Fax:877-887-8750
Practice Address - Street 1:15141 WHITTIER BLVD STE 360
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2184
Practice Address - Country:US
Practice Address - Phone:626-912-5767
Practice Address - Fax:562-360-1443
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49282207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty