Organization Active NPI

Kiran Mahl-Sansone M.D., Inc.

  • Specialist
  • Vista, CA
National Provider Identifier
1104861897
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G77576 Issued in CA
Legal business name
KIRAN MAHL-SANSONE M.D., INC.
Practice address
2067 W Vista Way
Suite 200
Vista, CA 92083-6031
Phone
(760) 726-2180
Fax
(760) 726-9928
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Andrea Scott
Title
Billing Specialist
Phone
(760) 726-2180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G77576 CA Primary

Addresses

Primary practice location

2067 W Vista Way
Suite 200
Vista, CA 92083-6031

Mailing address

2067 W Vista Way
Suite 200
Vista, CA 92083-6031
Phone (760) 726-2180

National Provider Directory

National Provider Directory

Locations

2067 W Vista Way
Ste 200
Vista, CA 92083
Phone (760) 726-2180

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505692800000",
    "number": "1104861897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "SUITE 200",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-726-2180",
            "fax_number": "760-726-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "SUITE 200",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-726-2180",
            "fax_number": "760-726-9928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRAN MAHL-SANSONE M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2017-09-18",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "760-726-2180",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G77576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.