Peter N Mansour
Individual provider Active NPI Pharmacist · Duarte, CA
NPI 1982997771 · NPPES record last updated May 26, 2011
Key facts
- NPI
- 1982997771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 58968 (CA)
- Practice address
- 1050 Huntington Dr
Duarte, CA 91010-2475 - Phone
- (626) 803-0003
- NPI assigned
- May 26, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58968 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 58968 | CA | Yes |
Addresses
Primary practice location
1050 Huntington Dr
Duarte, CA 91010-2475
Mailing address
1432 S Meeker Ave
West Covina, CA 91790-3206
Phone (626) 665-7383
Other providers in Duarte, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.