Provider Demographics
NPI:1023350675
Name:MCMAHON, PAUL J (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:MCMAHON
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 1:216 CATALONIA AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6737
Mailing Address - Country:US
Mailing Address - Phone:503-420-7472
Mailing Address - Fax:
Practice Address - Street 1:6015 N INTERSTATE AVE APT 437
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-4792
Practice Address - Country:US
Practice Address - Phone:503-420-7472
Practice Address - Fax:956-394-1074
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1479752084P0800X
ORMD1880302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry