Individual
MARY ELLEN MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
636 HARRIS ST STE A, EUREKA, CA 95503-4448
(707) 476-0690
(707) 476-0692
Mailing address
PO BOX 990208, REDDING, CA 96099-0208
(530) 212-0073
(844) 440-2311
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G48569
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G485690
—
CA
Enumeration date
01/30/2006
Last updated
02/02/2024
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