Provider Demographics
NPI:1245525724
Name:MCCLAIN, LAUREN ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:MCCLAIN CHENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:800 BRADBURY DR SE STE 116
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4310
Mailing Address - Country:US
Mailing Address - Phone:505-272-1476
Mailing Address - Fax:505-925-1191
Practice Address - Street 1:MSC10 5610 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-8708
Practice Address - Country:US
Practice Address - Phone:505-272-9359
Practice Address - Fax:505-925-1191
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2021-0947208600000X
WAMD61078132208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery