Individual
DR. WILLIAM MATTHEW MAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 CYPRESS ST STE D, FORT BRAGG, CA 95437-5411
(707) 964-5696
(707) 964-6274
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
G30967
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOG309670
—
CA
Enumeration date
07/24/2006
Last updated
02/15/2012
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