Mani Mahdyoon, M.D., a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MANI MAHDYOON, M.D., A PROFESSIONAL CORPORATION

Practice address

845 S Fairmont Ave
Suite #5
Lodi, CA 95240-5113

Phone

(209) 366-2360

Fax

(209) 366-2352

NPI assigned

Jul 31, 2007

Last updated

Dec 31, 2015By 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

Mani Mahdyoon, M.D.NPI 1144232349

Title

President

Phone

(209) 366-2360

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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.

• Mani Mahdyoon, MD

  • Internal Medicine Physician
  • Lodi, CA
  • NPI 1144232349
  Medicare reassignment NPD Authorized official
• Ronald Gary Navone, M.D.

  • Internal Medicine Physician
  • Lodi, CA
  • NPI 1225144934
  NPD (past)

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451520000000",
    "number": "1467642900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 S FAIRMONT AVE",
            "address_2": "SUITE #5",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405113",
            "telephone_number": "209-366-2360",
            "fax_number": "209-366-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S FAIRMONT AVE",
            "address_2": "SUITE #5",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405113",
            "telephone_number": "209-366-2360",
            "fax_number": "209-366-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANI MAHDYOON, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2015-12-31",
        "status": "A",
        "authorized_official_last_name": "MAHDYOON",
        "authorized_official_first_name": "MANI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-366-2360",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ghaus M Malik, MD
• Mallard Inpatient Physicians
• Alexander Scott Malm
• Megan Geiger Malone, DPT
• Brianna Malta
• Sarah Mann, NP
• Taylor Manous
• Mazen Muhammad Mardini, MD
• Nancy Mardis, LCSW
• Esmeralda Marquez, D.D.S.

• Internal Medicine Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.