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NPI Code Detail

MEDICARE: AMARDEEP S MANN MD MEDICAL CORPORATION

MEDICARE: AMARDEEP S MANN MD MEDICAL CORPORATION
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
1207RC0000XCardiovascular Disease PhysicianA65477CA

General Provider Information

NPI Number : 1568726743
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMARDEEP S MANN MD MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 865 PATRIOT DR STE 201
Second Line :
City : MOORPARK
State : CA
Zip : 93021-3407
Country : US
Telephone Number : 818-609-1995
Fax Number : 818-609-1771
Provider Business Practice Location Address
First Line : 865 PATRIOT DR STE 201
Second Line :
City : MOORPARK
State : CA
Zip : 93021-3407
Country : US
Telephone Number : 818-609-1995
Fax Number : 818-609-1771
Authorized Official
Title or Position : PHYSICIAN
Name : AMARDEEP S MANN
Credential : MD
Telephone Number : 818-609-1995
Provider Enumeration Date : 07/02/2012
Last Update Date : 07/02/2012

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