Individual
ANDREW MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
128 CARL ST, APT 1, SAN FRANCISCO, CA 94117-3923
(619) 981-9814
Mailing address
128 CARL ST, APT 1, SAN FRANCISCO, CA 94117-3923
(619) 981-9814
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002845
PA
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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