MEDICARE: DR. ROSALINDA ARLEEN MANDREZA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	C043151	CA

General Provider Information

NPI Number	:	1336197185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSALINDA ARLEEN MANDREZA MD

Provider Business Mailing Address
First Line	:	2593 S KING RD
Second Line	:	STE. 11
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1880
Country	:	US
Telephone Number	:	408-274-2880
Fax Number	:	408-274-5166

Provider Business Practice Location Address
First Line	:	2593 S KING RD
Second Line	:	STE. 11
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1880
Country	:	US
Telephone Number	:	408-274-2880
Fax Number	:	408-274-5166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	08/23/2012

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