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General NPI Number Information
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NPI Number | 1437108347
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Entity Type | Individual
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Provider Name | RANA MANSOUR D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 230 AVOCADO AVE
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City | EL CAJON
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State | CA
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Zip | 92020-4604
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Country | US
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Telephone | 619-444-2192
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Fax | 619-444-3531
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Provider Business Mailing Address
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Address Line | 7301 GIRARD AVE SUITE 202
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City | LA JOLLA
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State | CA
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Zip | 92037-5125
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Country | US
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Telephone | 858-454-7133
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Fax | 858-454-7706
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E4688
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License Number State | CA
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