Mandarin OB-GYN PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME77915 Issued in FL

Legal business name

MANDARIN OB-GYN PA

Practice address

13241 Bartram Park Blvd Unit 1309
Jacksonville, FL 32258-5229

Phone

(904) 288-6910

Fax

(904) 288-6916

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Ghulam Quadir Khan, MD

Title

President

Phone

(904) 288-6910

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515110400000",
    "number": "1407956972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 1309",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585229",
            "telephone_number": "904-288-6910",
            "fax_number": "904-288-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 1309",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585229",
            "telephone_number": "904-288-6910",
            "fax_number": "904-288-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDARIN OB-GYN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2018-01-05",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "GHULAM",
        "authorized_official_middle_name": "QUADIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-288-6910",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME77915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256632000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mandarin Chiropractic Center PA
• Mandarin Counseling Inc
• Mandarin Eyecare Assoc, Inc
• Mandarin Family Medicine, P.a.
• Mandarin Healing Center Inc
• Mandarin Reading Clinic
• Mandarin South Dentistry PA
• Mandarin Vision Center Inc
• David M. Mandel, MD
• Kendall Mandt, RBT

• Obstetrics & Gynecology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; 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.