DR. WILLIAM MATTHEW MAHON M.D. NPI 1184646259

NPI Information

NPI: 1184646259
Provider Name: DR. WILLIAM MATTHEW MAHON, M.D.
Classification: Pediatrics - 2080A0000X
Entity Type: Individual

Specialization: Adolescent Medicine

Address:
510 CYPRESS ST STE D
FORT BRAGG, CA
ZIP 95437
Phone: (707) 964-5696
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DR. William Matthew Mahon, M.D. is an adolescent medicine pediatrics in Fort Bragg, CA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. William Matthew Mahon, M.D. NPI is 1184646259. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

510 CYPRESS ST STE D
FORT BRAGG, CA
ZIP 95437-411
Phone: (707) 964-5696
Fax: (707) 964-6274

The enumeration date for this NPI number is 7/24/2006 and was last updated on 2/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080A0000X	Pediatrics	Adolescent Medicine	G30967	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	553843	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
2	OOG309670	MEDICAID	CALIFORNIA
3	A44620	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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