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Individual

DR. CASSANDRA A MAHAN-RICHARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
(909) 864-1097
(951) 225-6879
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
G53986
CA
207KA0200X
Allergy Physician
MD60286895
WA
208000000X
Pediatrics Physician
Primary
G53986
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G646250
CA
01
MD60286895
WASHINGTON STATE LICENSE
WA
Enumeration date
05/17/2006
Last updated
09/16/2025
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