Michael Odell Mann, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G37019 Issued in CA

Practice address

3901 Lone Tree Way
Antioch, CA 94509-6200

Phone

(925) 779-7274

Fax

(925) 706-1686

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1922042811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4053 LONE TREE WAY",
            "address_2": "SUITE 102",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316200",
            "telephone_number": "925-756-3427",
            "fax_number": "925-756-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096200",
            "telephone_number": "925-779-7274",
            "fax_number": "925-706-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "MICHAEL",
        "middle_name": "ODELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G37019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF CA",
            "identifier": "00G370190",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G370190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary-Ann Malik, MD
• Ryan Manalo, PHARMD
• Marilyn Anne Mancusi, RADT
• Aurora Mandy, MS,
• Sue G Mankini, CATC
• Carolyn S. Manson, MD
• Anupam M Mapara, M.D.
• Marc Home Health Agency LLC
• Jenna Marchesi-Osborn
• Mickie Marchetti

• Anesthesiology Physician in Antioch, CA
• Providers in Antioch, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.