| Doctor Name: | DR. LAWRENCE DALE MCNUTT |
| NPI Number: | 1609070846 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A83196 |
| Business Practice Address: | 18436 Roscoe Blvd Northridge, CA - 913254107 |
| Business Phone Number: | 8184351800 |
| Business Fax Number: | 8184351490 |
| Mailing Address: | 7521 Edinger Ave Unit 4245, HUNTINGTON BEACH |
| State: | CA |
| Postal Code: | 926470610 |
| Phone Number: | 7146559779 |
| Fax Number: | |
| NPI Enumeration Date: | 06/12/2007 |
| NPI Last Update Date: | 12/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | A83196 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |