Fred and Mary Mansubi, M.D. a Professional Medical Corporation

Primary specialty

Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X

License

A262890 Issued in CA

Legal business name

FRED AND MARY MANSUBI, M.D. A PROFESSIONAL MEDICAL CORPORATION

Practice address

2577 Samaritan Dr
Suite 860
San Jose, CA 95124-4100

Phone

(408) 358-2627

Fax

(408) 356-6445

NPI assigned

Jul 11, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Mehri (Mary) Mansubi, M.D.

Title

Owner

Phone

(408) 358-2627

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1114126034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DR",
            "address_2": "SUITE 860",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244100",
            "telephone_number": "408-358-2627",
            "fax_number": "408-356-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DR",
            "address_2": "SUITE 860",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244100",
            "telephone_number": "408-358-2627",
            "fax_number": "408-356-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED AND MARY MANSUBI, M.D. A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "MANSUBI",
        "authorized_official_first_name": "MEHRI (MARY)",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-358-2627",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A330510",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "CA",
            "license": "A262890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Lynn Fraser, MD
• Melissa Fraser
• Liliana Frausto, THERAPIST
• Victoriano Frausto, RDN
• Marilyn Frazier
• Fred Finch Youth Center
• Ross Fredell
• Frederick P. Benson, MD, Inc
• Randi Fredricks, PHD
• Anna Freedland

• Pediatric Allergy/Immunology Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Pediatric Allergy/Immunology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.