Organization
JESSICA MANTILLA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA P MANTILLA MD (PRESIDENT)
(951) 929-6260
Entity
Organization
Contact information
Practice address
100 S RAYMOND AVE, ALHAMBRA, CA 91801-3166
(951) 929-6260
(951) 765-2855
Mailing address
PO BOX 788, HEMET, CA 92546-0788
(951) 929-6260
(951) 765-2855
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A110850
CA
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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