Provider Demographics
NPI:1922104512
Name:MAHONEY, HELEN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:MARIE
Last Name:MAHONEY
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:PO BOX 15798
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-0798
Mailing Address - Country:US
Mailing Address - Phone:562-431-5103
Mailing Address - Fax:562-431-5124
Practice Address - Street 1:5242 KATELLA AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2820
Practice Address - Country:US
Practice Address - Phone:562-431-5103
Practice Address - Fax:562-431-5124
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62235207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G622351Medicaid
CAG62235Medicare ID - Type Unspecified
CA00G622351Medicaid