Individual
JEROME KEITH MANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 57326, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A196663
CA
208600000X
Surgery Physician
R74518
AZ
208C00000X
Colon & Rectal Surgery Physician
66926
MN
208C00000X
Colon & Rectal Surgery Physician
A196663
CA
Other
Enumeration date
06/03/2014
Last updated
09/10/2024
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