Provider Demographics
NPI:1326155839
Name:MCGOLDRICK, MARY RITA (NP)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:RITA
Last Name:MCGOLDRICK
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Gender:F
Credentials:NP
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Mailing Address - Street 1:5095 NEW HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-1933
Mailing Address - Country:US
Mailing Address - Phone:858-552-8585
Mailing Address - Fax:858-642-6255
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:858-642-6255
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CANP 14916363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health