Michael Robert Mahoney Jr.
Military Health Care Provider (Independent Duty Corpsman)

Address: 34800 Bob Wilson Dr Ste 14, San Diego, CA 92134-1014
Phone: 6366346383

Michael Robert Mahoney Jr. (NPI# 1144858317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1144858317
Entity Type Individual
Full Name Michael Robert Mahoney Jr.
Credential IDC
Gender Male
Practice Address 34800 Bob Wilson Dr Ste 14
San Diego
CA 92134-1014
Practice Telephone 6366346383
Mailing Address 9273 E Bent Creek Way
AZ 85747-5412
Mailing Telephone 6366346383
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2020-04-01
Last Update Date 2020-04-01

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 1710I1002X Military Health Care Provider · Independent Duty Corpsman Other Service Providers CA

Providers with the same name

NPI Name Taxonomy Address Enumeration
1497881965 Michael S Mahoney Internal Medicine 11795 Education St Ste 213, Auburn, CA 95602-2469 2007-02-26
1396840237 Michael Mahoney Emergency Medicine 29710 Urgent Care Dr, Daphne, AL 36526-9595 2006-09-14
1982171922 Michael Mahoney Counselor 3828 W Taylor St, Chicago, IL 60624-4027 2018-10-29
1841672052 Michael Mahoney Jr. Speech-Language Pathologist 13890 Braddock Rd, Ste. 207, Centreville, VA 20121-2435 2015-06-24
1659799500 Michael William Mahoney Counselor 1530 Assisi Dr Nw, Rochester, MN 55901-1637 2014-03-28
1659612448 Michael D Mahoney Counselor 1345 Birch Ave, Cottage Grove, OR 97424-1416 2013-03-05
1255689790 Michael Mahoney Counselor 8931 Huron St, Thornton, CO 80260-6806 2012-08-15
1912278334 Michael James Mahoney Surgery 50 Moisey Dr Ste 214, Hazle Township, PA 18202-9297 2012-01-17
1790929727 Michael Mahoney Case Manager/Care Coordinator 1407 Saint Andrew St Ste 100, La Crosse, WI 54603-2378 2009-04-21
1629297270 Michael Dennis Mahoney Obstetrics & Gynecology 29751 Little Mack Ave, Suite B, Roseville, MI 48066-6503 2007-04-24
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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1801492145 Felicia Leanna Roberts Military Health Care Provider 2267 Reed Ave, San Diego, CA 92109-5628 2020-12-10
1720684319 Brandon Young Military Health Care Provider 3401 Farenholt Ave Building 14, San Diego, CA 92134-0001 2020-12-08
1770180648 Darius Lee Sean Woods Military Health Care Provider 6033 Sandy Shore Ct, San Diego, CA 92139-1014 2020-10-05
1174130744 Daniel Carrera Military Health Care Provider 2645 W Canyon Ave Apt 450, San Diego, CA 92123-4700 2020-09-28
1316551740 Kyle Bode Francis Military Health Care Provider 3149 Murray Ridge Rd, San Diego, CA 92123-2917 2020-09-02
1255945069 Jeremy Lee Military Health Care Provider 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 2020-08-31
1013520667 Rashaad Brown Military Health Care Provider 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 2020-08-24
1932711934 Alvaro Daniel Macias Military Health Care Provider 8685 Rio San Diego Dr Apt 4344, San Diego, CA 92108-6560 2020-08-20
1689286189 Charles Luke Morris Military Health Care Provider 1675 Beta Ct, San Diego, CA 92126-7060 2020-08-18
1255943635 Stephon Peyton Frost Military Health Care Provider 2654 Mendonca Dr, San Diego, CA 92110-4263 2020-08-18
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Office Location

Street Address 34800 BOB WILSON DR STE 14
State CA
Zip Code 92134-1014

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477178457 Joseph Hunter Sampson Military Health Care Provider 34101 Farenholt Ave #14, San Diego, CA 92134 2020-06-15
1508495201 Benjamin Michael Taylor Military Health Care Provider Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 2020-04-04
1255870333 Dosh Page Physician Assistant Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 2017-02-22
1417328063 Noem Clay Gallego Military Health Care Provider 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 2015-10-08
1972999183 Justin Paul Lachney Military Health Care Provider 34101 Farenholt Avenue, San Diego, CA 92134 2015-04-14
1174963532 Ryan Anders Crane Otolaryngology Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 2013-07-01
1447591268 Amy B. Cornell Student in an Organized Health Care Education/Training Program 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 2013-03-04
1841562956 Christopher Patrick Androski Jr. Emergency Medical Technician, Basic Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 2012-02-04
1164717740 Jason James Weiner Internal Medicine Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 2011-06-13
1225320237 Kimberly Ann Thompson Student in an Organized Health Care Education/Training Program Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 2011-05-09
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Zip Code 92134

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.