Provider Demographics
NPI:1851603138
Name:MAWHINEY, JAMES R (DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:MAWHINEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78078 COUNTRY CLUB DR.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BERMUDA DUNES
Mailing Address - State:CA
Mailing Address - Zip Code:92203
Mailing Address - Country:US
Mailing Address - Phone:760-345-9934
Mailing Address - Fax:760-345-3086
Practice Address - Street 1:78078 COUNTRY CLUB DR
Practice Address - Street 2:SUITE 205
Practice Address - City:BERMUDA DUNES
Practice Address - State:CA
Practice Address - Zip Code:92203-8173
Practice Address - Country:US
Practice Address - Phone:760-345-9934
Practice Address - Fax:760-345-3086
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2877225100000X
CAPT37283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist