Organization Active NPI

Jasbir S Mann M D Inc a Professional Corporation

  • Multi-Specialty Clinic/Center
  • Anaheim, CA
National Provider Identifier
1750403382
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
A35052 Issued in CA
Legal business name
JASBIR S MANN M D INC A PROFESSIONAL CORPORATION
Practice address
1771 W Romneya Dr
Suite E
Anaheim, CA 92801-1817
Phone
(714) 895-1774
Fax
(714) 758-1485
NPI assigned
Apr 4, 2007
Last updated
Apr 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Authorized official

Name
Jasbir S Mann, M.D.NPI 1043332661
Title
President
Phone
(714) 895-1774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X A35052 CA Primary

Addresses

Primary practice location

1771 W Romneya Dr
Suite E
Anaheim, CA 92801-1817

Mailing address

PO Box 2007
Fullerton, CA 92837-0007
Phone (714) 895-1774

Other identifiers 1

IdentifierTypeStateIssuer
00A350520MedicaidCA

National Provider Directory

National Provider Directory

Locations

1771 W Romneya Dr
Ste E
Anaheim, CA 92801
Phone (714) 449-0011

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1750403382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2007",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928370007",
            "telephone_number": "714-895-1774",
            "fax_number": "714-758-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 W ROMNEYA DR",
            "address_2": "SUITE E",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011817",
            "telephone_number": "714-895-1774",
            "fax_number": "714-758-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASBIR S MANN M D INC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "JASBIR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-895-1774",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A35052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A350520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.