MEDICARE: CYRIL FREDERICK PAUL MAHOOD 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
1	207Y00000X	Otolaryngology Physician	A46306	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A463060	OTHER	CA	MEDI CAL

General Provider Information

NPI Number	:	1598762742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYRIL FREDERICK PAUL MAHOOD MD

Provider Business Mailing Address
First Line	:	3000 CORTE HERMOSA
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-3248
Country	:	US
Telephone Number	:	949-640-1265
Fax Number	:

Provider Business Practice Location Address
First Line	:	9940 TALBERT AVE
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-5153
Country	:	US
Telephone Number	:	714-964-6229
Fax Number	:	714-378-6233

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	02/07/2013

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