Individual
MR. MICHAEL WILLIAM MANDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4510 PERALTA BLVD STE 1, FREMONT, CA 94536-5755
(510) 713-3202
(510) 713-0684
Mailing address
4510 PERALTA BLVD STE 1, FREMONT, CA 94536-5755
(510) 713-3202
(510) 713-0684
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
010010AN
CA
Other
Enumeration date
02/11/2009
Last updated
02/11/2009
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