Provider Demographics
NPI:1619230810
Name:MULROY, PATRICK JASON (DO)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JASON
Last Name:MULROY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 KATELLA AVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3309
Mailing Address - Country:US
Mailing Address - Phone:562-344-1350
Mailing Address - Fax:
Practice Address - Street 1:3851 KATELLA AVE
Practice Address - Street 2:SUITE 155
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2600
Practice Address - Country:US
Practice Address - Phone:562-344-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13247207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine