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General NPI Number Information
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NPI Number | 1124276142
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Entity Type | Individual
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Provider Name | CINDY MARIE MCMAHON PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 300 SIERRA COLLEGE DR
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5082
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Country | US
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Telephone | 530-273-4376
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Fax | 530-273-6426
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Provider Business Mailing Address
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Address Line | 1281 DOG BAR RD
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City | COLFAX
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State | CA
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Zip | 95713-9515
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Country | US
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Telephone | 530-637-1114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA19851
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License Number State | CA
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