Provider Demographics
NPI:1144472580
Name:MCLEOD, MARGARET KATHLEEN (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:KATHLEEN
Last Name:MCLEOD
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 1:12168 MOUNT VERNON AVE APT 33
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5541
Mailing Address - Country:US
Mailing Address - Phone:909-991-9118
Mailing Address - Fax:
Practice Address - Street 1:12168 MOUNT VERNON AVE APT 33
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5541
Practice Address - Country:US
Practice Address - Phone:909-991-9118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE80405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine