Individual
MIGUEL SANTIAGO GONZALEZ MANCERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-3277
Mailing address
5200 WILSHIRE BLVD APT 328, LOS ANGELES, CA 90036-4693
(786) 757-3384
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
PTL5076
CA
Other
Enumeration date
01/27/2021
Last updated
01/27/2021
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