Individual
DR. JEROLD J. MANGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1950 S COUNTRY CLUB DR, MESA, AZ 85210-6008
(480) 969-1446
(480) 464-8652
Mailing address
1950 S COUNTRY CLUB DR, MESA, AZ 85210-6008
(480) 969-1446
(480) 464-8652
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11635
AZ
207Q00000X
Family Medicine Physician
Primary
11635
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z6143
HEALTHNET
AZ
Enumeration date
03/18/2006
Last updated
04/24/2008
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