Individual
DAVID W. MANTIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
963 BUTTE ST, REDDING, CA 96001-0828
(530) 245-5900
(530) 245-5909
Mailing address
2160 COLONIAL BLVD, FORT MYERS, FL 33907-1410
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
25351
WV
2085R0001X
Radiation Oncology Physician
Primary
G34416
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G344161
—
CA
01
—
P00763965
RAILROAD MEDICARE
CA
Enumeration date
05/10/2006
Last updated
06/18/2020
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