MEHRAN MANDEGAR (NPI# 1174689335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174689335 |
Entity Type | Individual |
Full Name | MEHRAN MANDEGAR |
Credential | M.D. |
Practice Address |
5555 Grossmont Center Dr La Mesa CA 91942-3019 |
Mailing Address |
Po Box 26940 San Diego CA 92196-0940 |
Practice Telephone | 8886648297 |
Practice Fax Number | 8016506861 |
Mailing Telephone | 8886648297 |
Mailing Fax Number | 8016506861 |
Enumeration Date | 2006-12-29 |
Last Update Date | 2016-07-06 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
A63770 | CA | Allopathic & Osteopathic Physicians |
Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
A63770 | CA | Allopathic & Osteopathic Physicians |
N | 208M00000X | Hospitalist | A63770 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 1911036 | 05 |
Street Address |
5555 GROSSMONT CENTER DR |
City | LA MESA |
State | CA |
Zip Code | 91942-3019 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770589293 | Raed A Al-naser | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2005-06-21 |
1568062552 | Justin Cantley | Nurse Practitioner | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2020-10-28 |
1942828314 | Honey Mae Cosare Surmillon | Licensed Vocational Nurse | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2020-07-11 |
1922632801 | Susan Daniels | Occupational Therapist | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2020-02-28 |
1457917791 | Elpitha K Tsiskakis | Physician Assistant | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2019-05-13 |
1336601053 | Diane Wade Bloomberg | Dietitian, Registered | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2019-04-02 |
1265992846 | Vincent Crump | Registered Nurse | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2019-03-21 |
1295210029 | United Urology Consultants, P.C. | Urology | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2018-09-27 |
1639660368 | Aileen Cathy Chu | Pharmacist | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2018-05-29 |
1447767678 | Leslie Ling | Registered Nurse | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2018-01-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
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Taxonomy Code | 207RP1001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Pulmonary Disease |
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.