Mahan-Richards, Cassandra A

Mahan-Richards, Cassandra A is an individual health care provider with primary practice located at 11980 Mount Vernon Ave , Grand Terrace CA 92313-5172. She recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy, which is considered as her primary health care specialty. Mahan-Richards, Cassandra A can be contacted via phone (909) 864-1097.

Contact Information

Primary practice address
11980 Mount Vernon Ave Grand Terrace CA 92313-5172
Phone: (909) 864-1097
Fax: (951) 225-6879
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy 207KA0200X G53986 California
Allopathic & Osteopathic Physicians / Allergy 207KA0200X MD60286895 Washington

Profile Details

NPI number 1093767782
LBN Legal business name Mahan-Richards, Cassandra A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Mar 7th, 2023 - about 2 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 1093767782 NPPES
Washington Other MD60286895 WASHINGTON STATE LICENSE
Washington MEDICAID 00G646250 WASHINGTON STATE LICENSE

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