Individual provider Active NPI

Nadin Mansour, MD

  • Pediatrics Physician
  • Riverside, CA
National Provider Identifier
1144648908
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
140496 Issued in CA
Practice address
7392 Magnolia Ave
Riverside, CA 92504-3861
Phone
(951) 352-3330
NPI assigned
Mar 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 140496 CA Primary

Addresses

Primary practice location

7392 Magnolia Ave
Riverside, CA 92504-3861

Mailing address

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097

Other practice location 1

607 Donna Way
San Jacinto, CA 92583-5517
Phone (951) 654-0803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
140496CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nadin Mansour, MD Inc Pediatrics CurrentSince Feb 4, 2024 Accepting new patients

Locations

7392 Magnolia Ave
Riverside, CA 92504
Phone (951) 352-3330

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1144648908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097",
            "fax_number": "951-487-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7392 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043861",
            "telephone_number": "951-352-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 Donna Way",
            "address_purpose": "LOCATION",
            "city": "San Jacinto",
            "state": "CA",
            "postal_code": "925835517",
            "country_code": "US",
            "telephone_number": "951-654-0803",
            "fax_number": "951-487-9634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "NADIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-30",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "140496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.