NPIMap

Organization Active NPI

Mansoor Mosley MD

Doing business as South Bristol Medical Group

  • Specialist
  • Santa Ana, CA
National Provider Identifier
1124158324
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A41405 Issued in CA
Legal business name
MANSOOR MOSLEY MD
Doing business as
South Bristol Medical Group
Practice address
1220 Hemlock Way Ste 104
Santa Ana, CA 92707-3651
Phone
(714) 754-5400
Fax
(714) 754-6836
NPI assigned
Mar 6, 2007
Last updated
Nov 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Dr. Mansoor Mosley, MDNPI 1770675357
Title
Doctor
Phone
(714) 754-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A41405 CA Primary

Addresses

Primary practice location

1220 Hemlock Way Ste 104
Santa Ana, CA 92707-3651

Mailing address

1220 Hemlock Way Ste 104
Santa Ana, CA 92707-3651
Phone (714) 754-5400

Other names 1

  • SOUTH BRISTOL MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1124158324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 HEMLOCK WAY STE 104",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927073651",
            "telephone_number": "714-754-5400",
            "fax_number": "714-754-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 HEMLOCK WAY STE 104",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927073651",
            "telephone_number": "714-754-5400",
            "fax_number": "714-754-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSOOR MOSLEY MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "MOSLEY",
        "authorized_official_first_name": "MANSOOR",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "714-754-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A41405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH BRISTOL MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.