Healthcare Provider Details

I. General information

NPI: 1639199730
Provider Name (Legal Business Name): CYDNEY MARIE MAHONEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 W COVELL BLVD
DAVIS CA
95616-5645
US

IV. Provider business mailing address

2660 W COVELL BLVD
DAVIS CA
95616-5645
US

V. Phone/Fax

Practice location:
  • Phone: 530-747-3000
  • Fax: 530-747-3086
Mailing address:
  • Phone: 530-747-3000
  • Fax: 530-747-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC55389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: