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Individual

DR. MARK MANSOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3501 PALMER DR, SUITE 201, CAMERON PARK, CA 95682-8276
(530) 672-7040
Mailing address
PO BOX 45680, SAN FRANCISCO, CA 94145-0680
(530) 672-7040

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A86841
CA
207RR0500X
Rheumatology Physician
Primary
A86841
CA

Other

Enumeration date
12/01/2005
Last updated
10/12/2015
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