Provider Demographics
NPI:1114218351
Name:MCNAMARA, CORY DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:DANIEL
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 DIAMOND FLTS
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-1846
Mailing Address - Country:US
Mailing Address - Phone:310-918-7497
Mailing Address - Fax:
Practice Address - Street 1:180 NEWPORT CENTER DR STE 235
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0903
Practice Address - Country:US
Practice Address - Phone:949-999-4120
Practice Address - Fax:949-999-1698
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1461202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty