Jessica Mantilla MD Inc

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

A110850 Issued in CA

Legal business name

JESSICA MANTILLA MD INC

Practice address

100 S Raymond Ave
Alhambra, CA 91801-3166

Phone

(951) 929-6260

Fax

(951) 765-2855

NPI assigned

Jun 6, 2016

Organization subpart

No

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

Authorized official

Name

Jessica P Mantilla, MDNPI 1891957973

Title

President

Phone

(951) 929-6260

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Patricia Mantilla, MD

  • Infectious Disease Physician
  • Glendale, CA
  • NPI 1891957973
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1861841348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925460788",
            "telephone_number": "951-929-6260",
            "fax_number": "951-765-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S RAYMOND AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013166",
            "telephone_number": "951-929-6260",
            "fax_number": "951-765-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA MANTILLA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "MANTILLA",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-929-6260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A110850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Rha, MD PC
• Paola Jauregui
• Jaya Healthcare Nursing Inc.
• Jed Meyers Marriage and Family Therapy Inc
• Sara Jefferson
• Daniel Jeung
• Jewel City Home Health Inc
• Annette Oi-Wan Jewik, LMFT
• Ruyan Jia
• Huinan Jiang

• Infectious Disease Physician in Alhambra, CA
• Providers in Alhambra, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.