Individual
SOPHIE MAHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 MERCY CIRCLE, CAMP PENDLETON, CA 92055-5191
(609) 712-1320
Mailing address
PO BOX 555191, CAMP PENDLETON, CA 92055-5191
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101279331
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2022
Last updated
08/28/2024
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