Provider Demographics
NPI:1841365970
Name:MCNEILL, ANNE MARIE C (MD, PHD)
Entity type:Individual
Prefix:MRS
First Name:ANNE MARIE
Middle Name:C
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:MISS
Other - First Name:ANNE MARIE
Other - Middle Name:C
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1441 AVOCADO AVE
Mailing Address - Street 2:SUITE 702
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1441 AVOCADO AVE
Practice Address - Street 2:SUITE 702
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7721
Practice Address - Country:US
Practice Address - Phone:949-706-7886
Practice Address - Fax:949-706-0681
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84330207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology