William M Mahon & Jeffrey M Kraut

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

WILLIAM M MAHON & JEFFREY M KRAUT

Doing business as

MENDOCINO COAST PEDIATRIC MDCL GRP

Practice address

510 Cypress St Ste D
Fort Bragg, CA 95437-5411

Phone

(707) 964-5696

Fax

(707) 964-6274

NPI assigned

Jul 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William Matthew Mahon, M.D.

Title

Partner/Administrator

Phone

(707) 964-5696

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MENDOCINO COAST PEDIATRIC MDCL GRP Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292457600000",
    "number": "1184644627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 CYPRESS ST STE D",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375411",
            "telephone_number": "707-964-5696",
            "fax_number": "707-964-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CYPRESS ST STE D",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375411",
            "telephone_number": "707-964-5696",
            "fax_number": "707-964-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM M MAHON & JEFFREY M KRAUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-12-16",
        "status": "A",
        "authorized_official_last_name": "MAHON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PARTNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "707-964-5696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ79185Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53843F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MENDOCINO COAST PEDIATRIC MDCL GRP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Wells, DC
• Faye Whatley, IHP
• Sheri Lynn White-Hackley, PT
• Katharine L. White, LMFT
• Neil Steven Wilensky, D.D.S.
• William M Mahon & Jeffrey M Kraut Mendocino Coast Pediatric MDCL GRP
• Matthew Simon Winslow
• John Wiser, MFT
• Womens Health Center
• Jocelyn Woodason

• Pediatric Adolescent Medicine Physician in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Pediatric Adolescent Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.