Organization
MANDEGAR MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHRAN MANDEGAR MD (PRESIDENT)
(858) 220-1907
Entity
Organization
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(858) 220-1907
Mailing address
PO BOX 26940, SAN DIEGO, CA 92196-0940
(858) 220-1907
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A637700
—
CA
Enumeration date
05/22/2007
Last updated
09/22/2016
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