Mandryk, Ted M

Mandryk, Ted M is an sole proprietor health care provider with primary practice located at 3291 Loma Vista Rd , Ventura CA 93003-3099. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Mandryk, Ted M can be contacted via phone (805) 652-6165.

Contact Information

Primary practice address
3291 Loma Vista Rd Ventura CA 93003-3099
Phone: (805) 652-6165
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X G64121 California
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X G64121 California

Profile Details

NPI number 1164413886
LBN Legal business name Mandryk, Ted M
Credentials MEDICAL DOCTOR
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2005
Last updated Feb 29th, 2008 - about 16 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 1164413886 NPPES
California MEDICAID 00G641210

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