Organization
JEFFREY L MANSOOR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY L MANSOOR MD (PRESIDENT)
(209) 944-5550
Entity
Organization
Contact information
Practice address
525 W ACACIA ST, STOCKTON, CA 95203-2405
(209) 944-5550
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/06/2006
Last updated
03/08/2021
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