MEDICARE: MALIA AUDREY MCCARTHY M.D.

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
1	2084P0804X	Child & Adolescent Psychiatry Physician	A077208	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1568445450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALIA AUDREY MCCARTHY M.D.

Provider Business Mailing Address
First Line	:	2230 STOCKTON BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-1419
Country	:	US
Telephone Number	:	916-875-1183
Fax Number	:	916-734-3384

Provider Business Practice Location Address
First Line	:	9343 TECH CENTER DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95826-2563
Country	:	US
Telephone Number	:	916-875-1183
Fax Number	:	916-875-6904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	03/11/2014

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