Mandeville, Katherine Ann

Mandeville, Katherine Ann is an individual health care provider with primary practice located at 3020 Childrens Way , San Diego CA 92123-4223. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Mandeville, Katherine Ann can be contacted via phone (858) 966-8036.

Contact Information

Primary practice address
3020 Childrens Way San Diego CA 92123-4223
Phone: (858) 966-8036
Fax: (858) 966-7433
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X C149595 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C149595 California

Profile Details

NPI number 1649355397
LBN Legal business name Mandeville, Katherine Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649355397 NPPES
Colorado MEDICAID 22807349

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