Organization
WILLIAM M MAHON & JEFFREY M KRAUT
Active
Other names
MENDOCINO COAST PEDIATRIC MDCL GRP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM MATTHEW MAHON M.D. (PARTNER/ADMINISTRATOR)
(707) 964-5696
Entity
Organization
Contact information
Practice address
510 CYPRESS ST STE D, FORT BRAGG, CA 95437-5411
(707) 964-5696
(707) 964-6274
Mailing address
510 CYPRESS ST STE D, FORT BRAGG, CA 95437-5411
(707) 964-5696
(707) 964-6274
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM53843F
—
CA
05
—
ZZZ79185Z
—
CA
Enumeration date
07/20/2006
Last updated
12/16/2010
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