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Organization

CONCEPCION R MANGASEP M.D, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CONCEPCION REYES MANGASEP M.D (MEDICAL DOCTOR)
(702) 818-6032
Entity
Organization

Contact information

Practice address
7661 PUERTO RICO DR, BUENA PARK, CA 90620-1270
(702) 818-6032
(714) 363-5539
Mailing address
7661 PUERTO RICO DRIVE, BUENA PARK, CA 90620-1270
(702) 818-6032
(714) 363-5539

Taxonomy

Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
A66574
CA

Other

Enumeration date
09/24/2014
Last updated
09/24/2014
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