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General NPI Number Information
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NPI Number | 1598213316
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Entity Type | Organization
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Legal Business Name | ANDREA MANN, DO, PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 125 N ACACIA AVE STE 107
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1177
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Country | US
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Telephone | 858-215-1667
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Fax | 858-724-1463
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Provider Business Mailing Address
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Address Line | 125 N ACACIA AVE STE 107
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1177
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Country | US
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Telephone | 858-215-1667
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Fax | 858-724-1463
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANDREA MANN
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Credential | DO
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Telephone | 858-215-1667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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