Individual
MARIE KATHERINE MULCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-S
Contact information
Practice address
801 E CHAPMAN AVE STE 203, FULLERTON, CA 92831-3846
(714) 680-9000
(714) 680-8233
Mailing address
PO BOX 919, FULLERTON, CA 92836-0919
(714) 680-9000
(714) 680-8233
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10618366-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2017
Last updated
11/08/2021
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