Individual
MEHRAN MANDEGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(888) 664-8297
(801) 650-6861
Mailing address
PO BOX 26940, SAN DIEGO, CA 92196-0940
(888) 664-8297
(801) 650-6861
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A63770
CA
207RP1001X
Pulmonary Disease Physician
Primary
A63770
CA
208M00000X
Hospitalist Physician
A63770
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1911036
—
CA
Enumeration date
12/29/2006
Last updated
08/09/2023
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