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General NPI Number Information
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NPI Number | 1841605128
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Entity Type | Organization
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Legal Business Name | RANA MANSOUR ADVANCED PODIATRY INSTITUTE, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 343 E LEXINGTON AVE SUITE 101
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City | EL CAJON
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State | CA
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Zip | 92020-4520
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Country | US
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Telephone | 619-442-1987
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Fax | 619-456-9775
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Provider Business Mailing Address
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Address Line | 343 E LEXINGTON AVE SUITE 101
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City | EL CAJON
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State | CA
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Zip | 92020-4520
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Country | US
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Telephone | 619-442-1987
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Fax | 619-456-9775
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Authorized Official
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Title or Position | SOLE PROPIETOR
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Name | DR. RANA MANSOUR
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Credential | D. P. M.
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Telephone | 619-442-1987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4688
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License Number State | CA
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