Mandyam, Vijay
Mandyam, Vijay is an sole proprietor health care provider with primary practice located at 43713 20Th St W Ste 5 , Lancaster CA 93534-4628. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Mandyam, Vijay can be contacted via phone (661) 945-8700.Contact Information
Primary practice address
43713 20Th St W Ste 5
Lancaster CA 93534-4628
Phone: (661) 945-8700
Fax: (661) 945-8757
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | E4071 | California |
Profile Details
| NPI number | 1174618672 |
|---|---|
| LBN Legal business name | Mandyam, Vijay |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Dec 6th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174618672 | NPPES |
| California | MEDICAID | 000E40711 |
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