Provider Demographics
NPI:1336140656
Name:LAUGHLIN, DONELLE A (MD)
Entity Type:Individual
Prefix:DR
First Name:DONELLE
Middle Name:A
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:MD
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 1711
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-1711
Mailing Address - Country:US
Mailing Address - Phone:831-649-0175
Mailing Address - Fax:831-646-0220
Practice Address - Street 1:889 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4463
Practice Address - Country:US
Practice Address - Phone:831-649-0175
Practice Address - Fax:831-646-0220
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65672207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H20791Medicare UPIN
CA00A656720Medicare ID - Type Unspecified