Individual
MEDHAT MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2105 BEVERLY BLVD, SUITE 207, LOS ANGELES, CA 90057-2216
(213) 483-1007
(213) 483-3207
Mailing address
2105 BEVERLY BLVD, SUITE 207, LOS ANGELES, CA 90057-2216
(213) 483-1007
(213) 483-3207
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A24055
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A240550
—
CA
01
—
A24055
MEDICAL LICENSE NUMBER
CA
Enumeration date
02/27/2007
Last updated
07/09/2007
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