MEDICARE: DANIEL RENE MCMAHON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1710I1002X	Independent Duty Corpsman		CA

General Provider Information

NPI Number	:	1558295139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL RENE MCMAHON

Provider Business Mailing Address
First Line	:	5275 MONROE AVE APT 40
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4757
Country	:	US
Telephone Number	:	661-330-6232
Fax Number	:

Provider Business Practice Location Address
First Line	:	5275 MONROE AVE APT 40
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4757
Country	:	US
Telephone Number	:	661-330-6232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “ DANIEL RENE MCMAHON ” Practice Location

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