Doctor Name: | MRS. MARY C. MURDOCK |
NPI Number: | 1023026192 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA 17168 |
Business Practice Address: | 539 S Brea Blvd Ste 100 Brea, CA - 928215377 |
Business Phone Number: | 7146712936 |
Business Fax Number: | |
Mailing Address: | 1850 Brea Blvd Apt 3, FULLERTON |
State: | CA |
Postal Code: | 928353946 |
Phone Number: | 7143693233 |
Fax Number: | |
NPI Enumeration Date: | 08/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA 17168 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |