Healthcare Provider Details

I. General information

NPI: 1790705531
Provider Name (Legal Business Name): ADITI H. MANDPE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CALIFORNIA ST RM 505
SAN FRANCISCO CA
94118-1507
US

IV. Provider business mailing address

3838 CALIFORNIA ST RM 505
SAN FRANCISCO CA
94118-1507
US

V. Phone/Fax

Practice location:
  • Phone: 415-751-4914
  • Fax: 415-751-1414
Mailing address:
  • Phone: 415-751-4914
  • Fax: 415-751-1414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberG78083
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: