Provider Demographics
NPI:1801862297
Name:FINEGAN, MARY M (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:FINEGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 FAIR OAKS BLVD
Mailing Address - Street 2:SUITE 355
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-5533
Mailing Address - Country:US
Mailing Address - Phone:916-927-3178
Mailing Address - Fax:916-927-1488
Practice Address - Street 1:2277 FAIR OAKS BLVD
Practice Address - Street 2:SUITE 355
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5533
Practice Address - Country:US
Practice Address - Phone:916-927-3178
Practice Address - Fax:916-927-1488
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76206207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH69713Medicare UPIN
CA00A762060Medicare ID - Type Unspecified