Individual
DR. JONATHON MICHAEL MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
14850 ROSCOE BLVD, PANORAMA CITY, CA 91402-4618
(818) 787-2222
Mailing address
PO BOX 5486, ORANGE, CA 92863-5486
(818) 550-0900
(505) 293-1524
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5101017820
MI
Other
Enumeration date
06/24/2008
Last updated
09/04/2012
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