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Individual

DR. VIJAY MANDYAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
43713 20TH ST W STE 5, LANCASTER, CA 93534-4628
(661) 945-8700
(661) 945-8757
Mailing address
43713 20TH ST W STE 5, LANCASTER, CA 93534-4628
(661) 945-8700
(661) 945-8757

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4071
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E40711
CA
Enumeration date
10/03/2006
Last updated
12/06/2023
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