# WILLIAM M MAHON & JEFFREY M KRAUT MENDOCINO COAST PEDIATRIC MDCL GRP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346410230
- **Authorized official:** WILLIAM MATTHEW MAHON M.D. (PARTNER/ADMINISTRATOR)
- **Authorized official phone:** (707) 964-5696

## Contact information

- **Practice address:** 510 CYPRESS ST STE D, FORT BRAGG, CA 95437-5411
- **Practice address phone:** (707) 964-5696
- **Practice address fax:** (707) 964-6274
- **Mailing address:** 510 CYPRESS ST STE D, FORT BRAGG, CA 95437-5411
- **Mailing address phone:** (707) 964-5696
- **Mailing address fax:** (707) 964-6274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 553843 | CA | Yes |

## Other

- **Enumeration date:** 03/06/2008
- **Last updated:** 06/16/2008