Provider Demographics
NPI:1588893788
Name:MCNALLY, PAUL DANIEL (ANP-BC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DANIEL
Last Name:MCNALLY
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Gender:M
Credentials:ANP-BC
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4510 EXECUTIVE DR
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3021
Mailing Address - Country:US
Mailing Address - Phone:858-643-5650
Mailing Address - Fax:858-643-5651
Practice Address - Street 1:4510 EXECUTIVE DR
Practice Address - Street 2:SUITE 125
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3021
Practice Address - Country:US
Practice Address - Phone:858-643-5650
Practice Address - Fax:858-643-5651
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA19028363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health