Provider Demographics
NPI:1215142419
Name:ONEILL, MARY MARGARET (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:MARGARET
Last Name:ONEILL
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 1:200 W CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1030
Mailing Address - Country:US
Mailing Address - Phone:408-583-0522
Mailing Address - Fax:408-583-0527
Practice Address - Street 1:200 W CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1030
Practice Address - Country:US
Practice Address - Phone:408-583-0522
Practice Address - Fax:408-583-0527
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG 69694207V00000X
CAG69694207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics