Provider Demographics
NPI:1679751408
Name:MCDONALD, ELLEN KATHLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:KATHLEEN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:800 FAIRMOUNT AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3150
Mailing Address - Country:US
Mailing Address - Phone:626-872-4195
Mailing Address - Fax:626-628-1836
Practice Address - Street 1:800 FAIRMOUNT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3150
Practice Address - Country:US
Practice Address - Phone:626-872-4195
Practice Address - Fax:626-628-1836
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2010-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA102543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine