Individual
DR. DANIEL P MANDELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
216 W PERKINS ST, SUITE 103, UKIAH, CA 95482-4800
(707) 462-1640
(707) 462-1640
Mailing address
216 W PERKINS ST, SUITE 103, UKIAH, CA 95482-4800
(707) 462-1640
(707) 462-1640
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G21073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G21073020
—
CA
Enumeration date
10/31/2006
Last updated
07/09/2007
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