Provider Demographics
NPI:1083901607
Name:MAYO, ARTHUR WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:WILLIAM
Last Name:MAYO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 MINER RD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-1429
Mailing Address - Country:US
Mailing Address - Phone:925-254-8066
Mailing Address - Fax:925-254-9194
Practice Address - Street 1:531 MINER RD
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-1429
Practice Address - Country:US
Practice Address - Phone:925-254-8066
Practice Address - Fax:925-254-9194
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-03
Last Update Date:2011-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG9217207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA58841Medicare UPIN