Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 41287 | CA |
N | 1223X0400X | Orthodontists | 41287 | CA |
NPI | 1063591501 |
---|---|
Provider Name | Dr. Kathleen L Mulcahey |
First Address | Valencia, CA 91355-4011 |
Second Address | Valencia, CA 91355-4011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 05/02/2008 |