Individual
RICHARD MEDHAT MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 HOAG DR, NEWPORT BEACH, CA 92663-4162
(949) 610-7245
(657) 241-7720
Mailing address
PO BOX 3589, NEWPORT BEACH, CA 92659-8589
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A81902
CA
208M00000X
Hospitalist Physician
Primary
A81902
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A819020
—
CA
01
—
P00616526
MEDICARE RAILROAD
CA
Enumeration date
12/08/2006
Last updated
05/30/2017
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