Individual provider Active NPI

Parvin Pam Mani, M.D.

  • Gynecology Physician
  • San Diego, CA
National Provider Identifier
1518925015
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
A52580 Issued in CA
Practice address
5555 Reservoir Dr, Ste 208
San Diego, CA 92120
Phone
(619) 583-7555
Fax
(619) 583-0555
NPI assigned
May 3, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X A52580 CA Primary

Addresses

Primary practice location

5555 Reservoir Dr, Ste 208
San Diego, CA 92120

Mailing address

5555 Reservoir Dr, Ste 208
San Diego, CA 92120
Phone (619) 583-7555

Other identifiers 1

IdentifierTypeStateIssuer
00A525800MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101115000309 CA Practitioner - Obstetrics/Gynecology 0345435475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Vanderbilt University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5555 Reservoir Dr
Suite 208
San Diego, CA 92120-5187
Phone (619) 583-7555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A52580CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parvin Mani, Inc Gynecology CurrentSince Aug 29, 2010 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

5555 Reservoir Dr
Ste 208
San Diego, CA 92120
Phone (619) 583-7555

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1518925015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR, STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92120",
            "telephone_number": "619-583-7555",
            "fax_number": "619-583-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR, STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92120",
            "telephone_number": "619-583-7555",
            "fax_number": "619-583-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANI",
        "first_name": "PARVIN",
        "middle_name": "PAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "A52580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A525800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.