Healthcare Provider Details

I. General information

NPI: 1902139405
Provider Name (Legal Business Name): PAUL T MCMAHON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 N MOUNTAIN AVE
UPLAND CA
91786-4111
US

IV. Provider business mailing address

2058 N MILLS AVE
CLAREMONT CA
91711-2812
US

V. Phone/Fax

Practice location:
  • Phone: 213-700-9900
  • Fax:
Mailing address:
  • Phone: 213-700-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY15721
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: