Mahoney, Mary Ellen
Mahoney, Mary Ellen is an sole proprietor health care provider with primary practice located at 636 Harris St Ste A , Eureka CA 95503-4448. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Mahoney, Mary Ellen can be contacted via phone (707) 476-0690.Contact Information
Primary practice address
636 Harris St Ste A
Eureka CA 95503-4448
Phone: (707) 476-0690
Fax: (707) 476-0692
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | G48569 | California |
Profile Details
| NPI number | 1750352621 |
|---|---|
| LBN Legal business name | Mahoney, Mary Ellen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Feb 2nd, 2024 - about 9 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750352621 | NPPES |
| California | MEDICAID | 00G485690 |
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