Organization
FRED AND MARY MANSUBI, M.D. A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEHRI (MARY) MANSUBI M.D. (OWNER)
(408) 358-2627
Entity
Organization
Contact information
Practice address
2577 SAMARITAN DR, SUITE 860, SAN JOSE, CA 95124-4100
(408) 358-2627
(408) 356-6445
Mailing address
2577 SAMARITAN DR, SUITE 860, SAN JOSE, CA 95124-4100
(408) 358-2627
(408) 356-6445
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A330510
CA
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
A262890
CA
Other
Enumeration date
07/11/2007
Last updated
03/06/2013
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