Healthcare Provider Details
I. General information
NPI: 1821151648
Provider Name (Legal Business Name): ALAN RICHARD MAYFIELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/19/2006
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
34800 BOB WILSON DR. BLDG 6, 3RD FLOOR, MENTAL HEALTH
SAN DIEGO CA
92134
US
IV. Provider business mailing address
34800 BOB WILSON DR. BLDG 6, 3RD FLOOR, MENTAL HEALTH
SAN DIEGO CA
92134
US
V. Phone/Fax
- Phone: 619-532-5666
- Fax: 619-532-5687
- Phone: 619-532-5666
- Fax: 619-532-5687
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | A94205 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | A94205 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: