Provider Demographics
NPI:1124276142
Name:MCMAHON, CINDY MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:MARIE
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 DOG BAR RD
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9515
Mailing Address - Country:US
Mailing Address - Phone:530-637-1114
Mailing Address - Fax:
Practice Address - Street 1:300 SIERRA COLLEGE DR
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5082
Practice Address - Country:US
Practice Address - Phone:530-273-4376
Practice Address - Fax:530-273-6426
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19851363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical