Healthcare Provider Details

I. General information

NPI: 1144304684
Provider Name (Legal Business Name): GERI LYNN MAHAFFEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 HANNA AVE STE 1
CORCORAN CA
93212-2314
US

IV. Provider business mailing address

1310 HANNA AVE STE 1
CORCORAN CA
93212-2314
US

V. Phone/Fax

Practice location:
  • Phone: 559-992-3300
  • Fax: 559-992-8962
Mailing address:
  • Phone: 559-992-3300
  • Fax: 559-992-8962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberF73885
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: