Mcilroy, Stacey

Mcilroy, Stacey is an individual health care provider with primary practice located at 22 Corporate Plaza Dr , Newport Beach CA 92660-7985. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Mcilroy, Stacey can be contacted via phone (949) 722-7038.

Contact Information

Primary practice address
22 Corporate Plaza Dr Newport Beach CA 92660-7985
Fax: (949) 630-4900
Website:

Health care specialties

Profile Details

NPI number 1639155740
LBN Legal business name Mcilroy, Stacey
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2005
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639155740 NPPES
Arizona MEDICAID 486549
Arizona Other P00021617
Arizona Other 86080015085259C297

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