MEDICARE: MONA MADANI M.D.

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	207Q00000X	Family Medicine Physician	54031	AZ
2	207Q00000X	Family Medicine Physician	A171558	CA

General Provider Information

NPI Number	:	1891112223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONA MADANI M.D.

Provider Business Mailing Address
First Line	:	520 N PROSPECT AVE STE 309
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3043
Country	:	US
Telephone Number	:	424-437-4700
Fax Number	:	424-437-8884

Provider Business Practice Location Address
First Line	:	520 N PROSPECT AVE STE 309
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3043
Country	:	US
Telephone Number	:	244-374-7004
Fax Number	:	424-437-4700

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

Provider Enumeration Date	:	03/24/2014
Last Update Date	:	08/13/2025

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Directions to “ MONA MADANI M.D.” Practice Location

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