Organization
CONCEPCION MANGASEP M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONCEPCION R MANGASEP M.D. (PRESIDENT)
(213) 422-2920
Entity
Organization
Contact information
Practice address
2918 MARINE AVE, GARDENA, CA 90249-3637
(310) 327-1212
(818) 670-7892
Mailing address
7661 PUERTO RICO DR, BUENA PARK, CA 90620-1270
(213) 422-2920
(818) 670-7892
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A66574
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A665740
—
CA
01
—
123853
LACO MENTAL HEALTH
CA
Enumeration date
10/03/2007
Last updated
07/22/2008
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