Provider Demographics
NPI:1255350237
Name:MCCLUNG, LAWSON EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:LAWSON
Middle Name:EUGENE
Last Name:MCCLUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3 LA ROCHELLE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6818
Mailing Address - Country:US
Mailing Address - Phone:949-759-0424
Mailing Address - Fax:949-272-3779
Practice Address - Street 1:359 SAN MIGUEL DR STE 303
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7809
Practice Address - Country:US
Practice Address - Phone:949-759-0424
Practice Address - Fax:949-272-3779
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC38370207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA36914Medicare UPIN