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Organization
STEVEN L MANDEL M D A PROFESSIONAL CORPORATION
Active
Organization
STEVEN L MANDEL M D A PROFESSIONAL CORPORATION
Active
Other names
Ketamine Clinics of Los Angeles
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL H MANDEL (COO)
(310) 270-0625
Entity
Organization
Contact information
Practice address
6801 PARK TER STE 525, LOS ANGELES, CA 90045-1543
(310) 270-0625
(310) 730-5993
Mailing address
6801 PARK TER STE 525, LOS ANGELES, CA 90045-1543
(310) 270-0625
(310) 730-5993
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G028631
CA
207L00000X
Anesthesiology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G286310
—
CA
Enumeration date
07/16/2007
Last updated
02/21/2023
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