MR. STUART J MACDONELL (NPI# 1407814247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407814247 |
| Entity Type | Individual |
| Full Name | MR. STUART J MACDONELL |
| Credential | PA-C |
| Practice Address |
204 Green Valley Rd Freedom CA 95019-3135 |
| Mailing Address |
525 South Dr Ste 115 Mountain View CA 94040-4211 |
| Practice Telephone | 8317282005 |
| Practice Fax Number | 8317283310 |
| Mailing Telephone | 6509695600 |
| Mailing Fax Number | 6509690360 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2018-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
54521 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
103850 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
204 GREEN VALLEY RD |
| City | FREEDOM |
| State | CA |
| Zip Code | 95019-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757428 | J. B. Physical Therapy, Inc. | Physical Therapist | 212 Green Valley Road, Freedom, CA 95019 | 2018-07-24 |
| 1639514441 | Isamar Baeza | Counselor | 2716 Freedom Blvd., Freedom, CA 95019 | 2013-05-07 |
| 1174891386 | Lisa Patrice Hamil | Pharmacist | 1810 Freedom Blvd., Freedom, CA 95019 | 2011-12-02 |
| 1346363710 | Chad Truong | Dentist | 2016 Freedom Boulevard, Freedom, CA 95019 | 2007-04-09 |
| 1962539585 | Frederick Wen Kang Chen | Internal Medicine | 243 Green Valley Rd Suite #e, Freedom, CA 95019 | 2007-02-28 |
| 1538277819 | Jacqueline Morris-lopez | Physician Assistant | 108 Green Valley Rd, Freedom, CA 95019 | 2006-08-28 |
| 1912979725 | Angela Molina | Anesthesiology | 160 Green Valley Rd Ste 101, Freedom, CA 95019 | 2006-02-06 |
| 1194704973 | David A South Md & Kim M Albridge Md A Medical Corporation | Dermatology | 204 Green Valley Road, Freedom, CA 95019 | 2006-01-11 |
| 1699232108 | Kayhan Mashouf Dmd Inc | Dentist | 270 Green Valley Rd, Freedom, CA 95019 | 2019-02-21 |
| 1194215434 | Hai Phu Duong | Pharmacist | 1810 Freedom Blvd, Freedom, CA 95019 | 2018-05-11 |
| Find all providers in zip 95019 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700259181 | Elizabeth Alexandra Bradbury | Physician Assistant | 150 Carnation Dr, Ste. 2, Freedom, CA 95019-3132 | 2015-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. STUART J MACDONELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.