Alan Mantell MD Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G18862 Issued in CA

Legal business name

ALAN MANTELL MD INC

Practice address

1818 Verdugo Blvd
Suite 304
Glendale, CA 91208-1403

Phone

(818) 790-3588

Fax

(818) 790-6518

NPI assigned

Nov 4, 2010

Organization subpart

No

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

Authorized official

Name

Alan Mantell, M.D.

Title

Owner

Phone

(818) 790-3588

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1679874879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 304",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081403",
            "telephone_number": "818-790-3588",
            "fax_number": "818-790-6518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 304",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081403",
            "telephone_number": "818-790-3588",
            "fax_number": "818-790-6518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN MANTELL MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "MANTELL",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-790-3588",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G18862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.