BENJAMIN REYES MANDAC (NPI# 1427014190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427014190 |
| Entity Type | Individual |
| Full Name | BENJAMIN REYES MANDAC |
| Credential | MD |
| Practice Address |
710 Lawrence Expy Santa Clara CA 95051-5173 |
| Practice Telephone | 4088519897 |
| Practice Fax Number | 4088511199 |
| Mailing Telephone | 4088519897 |
| Mailing Fax Number | 4088511199 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P0010X |
Physical Medicine & Rehabilitation Specialization: Pediatric Rehabilitation Medicine |
G55790 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G557900 | 05 |
| Street Address |
710 LAWRENCE EXPY |
| City | SANTA CLARA |
| State | CA |
| Zip Code | 95051-5173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699771030 | Lucy Song | Internal Medicine | 710 Lawrence Expy, Oncology Dept #440, Santa Clara, CA 95051-5173 | 2005-06-21 |
| 1124638465 | Eyad Jabra Kawwa | Physical Therapist | 710 Lawrence Expy, Santa Clara, CA 95051-5173 | 2020-08-02 |
| 1396374112 | Christopher Glen Low | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expy, Santa Clara, CA 95051-5173 | 2020-04-03 |
| 1780213603 | Jeannie Gail Evangelista Radoc | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expy, Santa Clara, CA 95051-5173 | 2020-04-02 |
| 1568091494 | David Feldman | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expy, Santa Clara, CA 95051-5173 | 2020-04-02 |
| 1609404847 | Steven M Herron | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expy, Santa Clara, CA 95051-5173 | 2020-04-01 |
| 1023646114 | Amber O'connor | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expy, Santa Clara, CA 95051-5173 | 2020-04-01 |
| 1780212068 | Andrew Le | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expy, Department 384 Gme, Santa Clara, CA 95051-5173 | 2020-03-31 |
| 1811525405 | Mahza Alam | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expy, Santa Clara, CA 95051-5173 | 2020-03-30 |
| 1003444514 | Stuart Andrew Green | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expy, Santa Clara, CA 95051-5173 | 2020-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043773690 | Christian Hamm | Pharmacist | Kaiser Permanente Medical Center Santa Clara, Dept 362 (inpatient Pharmacy), 710 Lawrence Expressway, Santa Clara, CA 95051 | 2019-04-10 |
| 1053879692 | Jiaqi Weng | Acupuncturist | 2062 Walsh Ave Suite B2, San Clare, CA 95051 | 2019-03-02 |
| 1699293209 | Leslie Avalos | Massage Therapist | 3530 Lochnivar Ave, Santa Clara, CA 95051 | 2017-09-04 |
| 1831552843 | Miral Neel Patel | Physical Therapist | 2737 Walsh Avenue, Alliance Occupational Medicine, Santa Clara, CA 95051 | 2016-03-29 |
| 1861831117 | Alison Wong | Emergency Medicine | 700 Lawrence Expy Dept 100, Santa Clara, CA 95051 | 2013-06-20 |
| 1073889291 | Brittany Lee Bianchi | Speech-Language Pathologist | 3775 Flora Vista Ave, Apt. 501, Santa Clara, CA 95051 | 2012-04-02 |
| 1124390067 | Karo Isajan | Chiropractor | 5145 Stevens Creek Blvd Ste 130, Santa Clara, CA 95051 | 2012-02-08 |
| 1598054991 | David Phillip Guo | Urology | 710 Lawrence Expy Dept 448, Santa Clara, CA 95051 | 2011-04-06 |
| 1043528573 | Jennifer Hui Young | Chiropractor | 2342 Walsh Ave, Santa Clara, CA 95051 | 2010-09-17 |
| 1386961217 | Assefa Gebremichael | Pharmacist | 1000 Kiely Blvd, #91, Santa Clara, CA 95051 | 2010-05-03 |
| Find all providers in zip 95051 | ||||
| Taxonomy Code | 2081P0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pediatric Rehabilitation Medicine |
| A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate for PRM was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Early discussions underway |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366925117 | Christine Marie Draper | Physical Medicine & Rehabilitation | 1900 Garden Rd Ste 200-c, Monterey, CA 93940-5373 | 2018-09-07 |
| 1922272525 | Elaine L Pico, M.d. | Physical Medicine & Rehabilitation | 2825 International Blvd, Room Rc121, Oakland, CA 94601-1543 | 2008-04-15 |
| 1295910941 | University Childrens Medical Group | Physical Medicine & Rehabilitation | 4650 W Sunset Blvd # 5, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1528080462 | Elaine Louise Pico | Physical Medicine & Rehabilitation | 3031 Telegraph Ave Ste 241, Berkeley, CA 94705-2053 | 2006-07-23 |
| 1205390655 | Rachel Sara Christensen | Physical Medicine & Rehabilitation | 1195 W Fremont Ave, Sunnyvale, CA 94087-3832 | 2019-01-29 |
| 1891265989 | Doreen Spearman | Physical Medicine & Rehabilitation | 34590 County Line Rd Ste 7, Yucaipa, CA 92399-5398 | 2018-11-30 |
| 1316445885 | Amy Quach | Physical Medicine & Rehabilitation | 8933 Activity Rd, San Diego, CA 92126-4427 | 2018-01-30 |
| 1619407459 | Shannon O'brien | Physical Medicine & Rehabilitation | 26081 Merit Cir Ste 107, Laguna Hills, CA 92653-7017 | 2017-06-14 |
| 1851844278 | Karen Charlotta Albiston | Physical Medicine & Rehabilitation | 3355 Mission Ave Ste 123, Oceanside, CA 92058-1327 | 2016-08-02 |
| 1033573126 | Faheem Mahomed | Physical Medicine & Rehabilitation | 4860 Y St Ste 3850, Sacramento, CA 95817-2307 | 2016-04-05 |
| Find all providers with the same taxonomy | ||||
| City | SANTA CLARA |
| Zip Code | 95051 |
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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.