Active NPI
Andrew Mangum, O.D.
- Optometrist
- San Francisco, CA
National Provider Identifier
1992147094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG002845
- Practice address
- 128 Carl St
Apt 1
San Francisco, CA 94117-3923 - Phone
- (619) 981-9814
- NPI assigned
- Jul 18, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG002845 | PA | Primary |
Addresses
Primary practice location
128 Carl St
Apt 1
San Francisco, CA 94117-3923
Mailing address
128 Carl St
Apt 1
San Francisco, CA 94117-3923
Phone (619) 981-9814
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG002845 | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374105600000",
"number": "1992147094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 CARL ST",
"address_2": "APT 1",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941173923",
"telephone_number": "619-981-9814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 CARL ST",
"address_2": "APT 1",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941173923",
"telephone_number": "619-981-9814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGUM",
"first_name": "ANDREW",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-18",
"last_updated": "2013-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG002845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.