Mandegar Medical Corp

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

A63770 Issued in CA

Legal business name

MANDEGAR MEDICAL CORP

Practice address

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Phone

(888) 664-8297

Fax

(801) 650-6861

NPI assigned

Aug 12, 2016

Last updated

Aug 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mehran Mandegar, MDNPI 1174689335

Title

Owner

Phone

(888) 664-8297

Specialties & licenses 3

Addresses

Other identifiers 1

Tax ID family

Mandegar Medical Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mandegar Medical Corp

  • Pulmonary Disease Physician
  • La Mesa, CA
  • NPI 1851500805
  NPD tax ID

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.

• Mehran Mandegar, M.D.

  • Pulmonary Disease Physician
  • La Mesa, CA
  • NPI 1174689335

  Critical Care Medicine

  NPD Authorized official

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1427502079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26940",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921960940",
            "telephone_number": "888-664-8297",
            "fax_number": "801-650-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "888-664-8297",
            "fax_number": "801-650-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDEGAR MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "MANDEGAR",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-664-8297",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A63770",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A63770",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A63770",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1911036",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Makdesi, DO
• Tulsi Mali, DMD
• James R Malinak, M.D.
• Eulyses Profeta Manalo
• Joyce M Mancini, NURSE PRACTITIONER
• Mandegar Medical Corp
• Mehran Mandegar, M.D.
• Benjamin J Mandel, D.D.S.
• Kaitlin Elizabeth Carter Mandel, WHNP/CNM
• Kelly Ann Mangan, LAC

• Pulmonary Disease Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.