Healthcare Provider Details

I. General information

NPI: 1972611192
Provider Name (Legal Business Name): ELIZABETH M MAHLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 ASHBY AVE ROOM 1002
BERKELEY CA
94705-2067
US

IV. Provider business mailing address

536 STURBRIDGE CT
WALNUT CREEK CA
94598-3921
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-1893
  • Fax: 510-649-8297
Mailing address:
  • Phone: 925-324-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA67827
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA67827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: