WILLIAM M MAHON & JEFFREY M KRAUT MENDOCINO COAST PEDIATRIC MDCL GRP (NPI# 1346410230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346410230 |
| Entity Type | Organization |
| Organization Name | WILLIAM M MAHON & JEFFREY M KRAUT MENDOCINO COAST PEDIATRIC MDCL GRP |
| Practice Address |
510 Cypress St Ste D Fort Bragg CA 95437-5411 |
| Practice Telephone | 7079645696 |
| Practice Fax Number | 7079646274 |
| Mailing Telephone | 7079645696 |
| Mailing Fax Number | 7079646274 |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | WILLIAM MATTHEW MAHON (PARTNER/ADMINISTRATOR) |
| Authorized Official Telephone | 7079645696 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
553843 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RHM53843F | 05 |
| Street Address |
510 CYPRESS ST STE D |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932178449 | Christopher Robshaw | Pediatrics | 510 Cypress St Ste D, Fort Bragg, CA 95437-5411 | 2006-03-16 |
| 1326335464 | Mendocino Coast Clinics, Inc | Clinic/Center | 510 Cypress St Ste D, Fort Bragg, CA 95437 | 2011-07-08 |
| 1285657189 | Jeffrey Malcolm Kraut | Pediatrics | 510 Cypress St Ste D, Fort Bragg, CA 95437-5411 | 2006-07-25 |
| 1184646259 | William Matthew Mahon | Pediatrics | 510 Cypress St Ste D, Fort Bragg, CA 95437-5411 | 2006-07-24 |
| 1184644627 | William M Mahon & Jeffrey M Kraut | Pediatrics | 510 Cypress St Ste D, Fort Bragg, CA 95437-5411 | 2006-07-20 |
| 1740225978 | Gayle Holderness Tyerman | Pediatrics | 510 Cypress St Ste D, Fort Bragg, CA 95437-5411 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588095848 | Ukiah Adventist Hospital | Clinic/Center | 850 Sequoia Cir, Fort Bragg, CA 95437-5490 | 2013-12-11 |
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| 1881232676 | Madera Community Hospital | Clinic/Center | 121 Belmont Ave., Suite 101, Mendota, CA 93640 | 2019-12-12 |
| 1790331817 | Valley Healthcare Centers | Clinic/Center | 252 N Highway 65, Lindsay, CA 93247-2702 | 2019-08-14 |
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| 1679038434 | Ridgecrest Regional Hospital | Clinic/Center | 105 E Sydnor Ave, Ridgecrest, CA 93555-5546 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
Please comment or provide details below to improve the information on WILLIAM M MAHON & JEFFREY M KRAUT MENDOCINO COAST PEDIATRIC MDCL GRP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.