Provider Demographics
NPI:1972664597
Name:DARREN JAMES MCDOW MD INC
Entity Type:Organization
Organization Name:DARREN JAMES MCDOW MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCDOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-410-9325
Mailing Address - Street 1:8540 S SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 1007
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3807
Mailing Address - Country:US
Mailing Address - Phone:310-410-9325
Mailing Address - Fax:310-410-9352
Practice Address - Street 1:8540 S SEPULVEDA BLVD
Practice Address - Street 2:SUITE 1007
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3807
Practice Address - Country:US
Practice Address - Phone:310-410-9325
Practice Address - Fax:310-410-9352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75639261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center