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Individual

ROY MANSANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1000 W CARSON ST, BOX 480, TORRANCE, CA 90502-2004
(310) 222-5026
Mailing address
1000 CARSON ST, BOX 480, TORRANCE, CA 90509
(310) 222-5026

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
A84716
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M050376
GROUP
CA
01
W14940
GROUP
CA
Enumeration date
05/23/2007
Last updated
11/14/2008
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