Healthcare Provider Details

I. General information

NPI: 1598762742
Provider Name (Legal Business Name): CYRIL FREDERICK PAUL MAHOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9940 TALBERT AVE
FOUNTAIN VALLEY CA
92708-5153
US

IV. Provider business mailing address

3000 CORTE HERMOSA
NEWPORT BEACH CA
92660-3248
US

V. Phone/Fax

Practice location:
  • Phone: 714-964-6229
  • Fax: 714-378-6233
Mailing address:
  • Phone: 949-640-1265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA46306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: