Mansoor Mosley MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

A41405 Issued in CA

Legal business name

MANSOOR MOSLEY MD

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

Organization subpart

No

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

Authorized official

Name

Dr. Mansoor Mosley, MD

Title

Doctor

Phone

(714) 754-5400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SOUTH BRISTOL MEDICAL GROUP Doing business as

Locations

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)…

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A414050 CA",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH BRISTOL MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eleazar Jason Pineda Mangilit, M.S., BCBA
• Jennifer Manning, P.T.
• Brianna Marie Manns
• Aina Elsa Manoj
• Nancy Marilin Manrique Ulloa, AMFT
• Roxan Mansoori Dara
• Nabil Mansour, PHARM D
• Wendy Champagne Mantecon
• Manuchehr M Darani MD Inc
• Clem-Ehros Manuel

• Specialist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Specialist in California

• 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.