Bose Mandava, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

C51112 Issued in CA

Practice address

825 North 10TH Street
Santa Paula, CA 93060

Phone

(805) 933-8600

Fax

(805) 933-8664

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Medical Center Anesthesia, LTD.

  • Anesthesiology Physician
  • Hoffman Estates, IL
  • NPI 1184689838
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1477609568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 LOMA VISTA RD",
            "address_2": "SUITE A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "93003",
            "telephone_number": "805-642-8565",
            "fax_number": "805-642-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NORTH 10TH STREET",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "93060",
            "telephone_number": "805-933-8600",
            "fax_number": "805-933-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAVA",
        "first_name": "BOSE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C5112",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C51112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C511120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmen Magana
• Christian Magana
• Sierra Reve Magana
• Jeff Ordonez Magbitang, PA-C
• Brittany Maldonado
• Wendy Sue Margolis, N.P.
• Iliana Marrero
• Daniella Martinez-Bretado, PPO
• Elena Martinez
• Kandice Martinez, ASW

• Anesthesiology Physician in Santa Paula, CA
• Providers in Santa Paula, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; 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.