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General NPI Number Information
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NPI Number | 1942811260
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Entity Type | Organization
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Legal Business Name | PETER MANN MD INC
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 7634 GIRARD AVE
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City | LA JOLLA
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State | CA
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Zip | 92037-4420
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Country | US
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Telephone | 858-412-3353
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Fax | 858-779-9361
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Provider Business Mailing Address
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Address Line | 7634 GIRARD AVE
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City | LA JOLLA
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State | CA
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Zip | 92037-4420
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Country | US
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Telephone | 858-412-3353
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Fax | 858-779-9361
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. PETER MANN
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Credential | MD
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Telephone | 858-412-3353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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