Provider Demographics
NPI:1730539008
Name:MCMAHON, ELIZABETH (OD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W 7TH ST STE G260
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3786
Mailing Address - Country:US
Mailing Address - Phone:213-623-5196
Mailing Address - Fax:
Practice Address - Street 1:700 W 7TH ST STE G260
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3786
Practice Address - Country:US
Practice Address - Phone:213-623-5196
Practice Address - Fax:213-623-5308
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33386152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist