Individual
MICHAEL ROBERT MAHONEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34800 BOB WILSON DR STE 14, SAN DIEGO, CA 92134-1014
(636) 634-6383
Mailing address
9273 E BENT CREEK WAY, TUCSON, AZ 85747-5412
(636) 634-6383
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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