Provider Demographics
NPI:1710290168
Name:NEIL D MULCAHY MD INC
Entity Type:Organization
Organization Name:NEIL D MULCAHY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTOLARYNGOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:MULCAHY
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:650-755-7552
Mailing Address - Street 1:1800 SULLIVAN AVE
Mailing Address - Street 2:SUITE 603
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2228
Mailing Address - Country:US
Mailing Address - Phone:650-755-7552
Mailing Address - Fax:
Practice Address - Street 1:1800 SULLIVAN AVE
Practice Address - Street 2:SUITE 603
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2228
Practice Address - Country:US
Practice Address - Phone:650-755-7552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA13250207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA13250OtherINDIVIDUAL NPI 1073546768
CA00A132500Medicare UPIN