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NPI Code Detail

MEDICARE: MR. ALVIN R MAHONEY MD

MEDICARE: MR. ALVIN R MAHONEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianG59931CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447257845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALVIN R MAHONEY MD
Provider Business Mailing Address
First Line : 2222 FOOTHILL BLVD
Second Line : # E570
City : LA CANADA
State : CA
Zip : 91011-1456
Country : US
Telephone Number : 818-636-8562
Fax Number : 888-235-1709
Provider Business Practice Location Address
First Line : 14850 ROSCOE BLVD
Second Line :
City : PANORAMA CITY
State : CA
Zip : 91402-4618
Country : US
Telephone Number : 818-904-3635
Fax Number : 888-235-1709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 06/21/2019

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