Marlon G Mangahas MD LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2007006296 Issued in MO

Legal business name

MARLON G MANGAHAS MD LLC

Practice address

11477 Olde Cabin Rd
Suite 210
Creve Coeur, MO 63141-7130

Phone

(314) 997-5208

Fax

(314) 997-5368

NPI assigned

Mar 18, 2011

Organization subpart

No

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

Authorized official

Name

Marlon Mangahas, MD

Title

Owner

Phone

(636) 942-2223

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1902105745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11477 OLDE CABIN RD",
            "address_2": "SUITE 210",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417130",
            "telephone_number": "314-997-5208",
            "fax_number": "314-997-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11477 OLDE CABIN RD",
            "address_2": "SUITE 210",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417130",
            "telephone_number": "314-997-5208",
            "fax_number": "314-997-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLON G MANGAHAS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "MANGAHAS",
        "authorized_official_first_name": "MARLON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-942-2223",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2007006296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Elayne Malone, PTA
• Jacklyn Michelle Malt, PT
• Rachael Jeanette Mangiore, AUD
• Kristen Nicole Marino, MSN, FNP-C
• Caroline Markun, DPT
• Thao Tran Marquez, MD,MS
• Tammy Anne Martielli, PH.D.
• Alayna Martin, SLP
• Corey Martin
• Nicole Michelle Martinez, M.D.

• Psychiatry Physician in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.