MEDICARE: DR. DAVID MANSOUR DO

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	5101025043	MI
2	207R00000X	Internal Medicine Physician	20A19086	CA

General Provider Information

NPI Number	:	1689164949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MANSOUR DO

Provider Business Mailing Address
First Line	:	3199 CAMINO DE LAS PIEDRAS
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-2855
Country	:	US
Telephone Number	:	619-905-9568
Fax Number	:

Provider Business Practice Location Address
First Line	:	181 REA AVE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3985
Country	:	US
Telephone Number	:	193-120-0347
Fax Number	:

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

Provider Enumeration Date	:	05/12/2018
Last Update Date	:	02/27/2024

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Directions to “ DR. DAVID MANSOUR DO” Practice Location

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