Provider Demographics
NPI:1801097241
Name:MCNEIL, CANDICE P (MD)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:P
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5000 HOPYARD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3348
Mailing Address - Country:US
Mailing Address - Phone:800-617-7717
Mailing Address - Fax:865-560-7381
Practice Address - Street 1:5000 HOPYARD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3348
Practice Address - Country:US
Practice Address - Phone:800-617-7717
Practice Address - Fax:865-560-7381
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2009-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN0266207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0026727OtherINSTITUTIONAL PERMIT