Doctor Name: | LYDIA MACKEOGH |
NPI Number: | 1114150877 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 66 Hurlbut Street Pacific Clinics Pasadena, CA - 91105 |
Business Phone Number: | 6264414221 |
Business Fax Number: | |
Mailing Address: | 1127 E Del Mar Blvd Apt 317, PASADENA |
State: | CA |
Postal Code: | 911063438 |
Phone Number: | 6268186326 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2009 |
NPI Last Update Date: | 08/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Rehabilitation Practitioner |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |