Basic Information
| Provider Information | |||||||||
| NPI: | 1619230810 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MULROY | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | JASON | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3851 KATELLA AVE | ||||||||
| Address2: | SUITE 155 | ||||||||
| City: | LOS ALAMITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907203309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5623441350 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3851 KATELLA AVE | ||||||||
| Address2: | SUITE 155 | ||||||||
| City: | LOS ALAMITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907202600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5623441350 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2012 | ||||||||
| LastUpdateDate: | 08/17/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 20A13247 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.