Mantell, Michael R.
Mantell, Michael R. is an sole proprietor health care provider with primary practice located at 5565 Grossmont Center Dr Building 1, Suite 223, La Mesa CA 91942-3020. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Mantell, Michael R. can be contacted via phone (619) 644-1111.Contact Information
Primary practice address
5565 Grossmont Center Dr Building 1, Suite 223
La Mesa CA 91942-3020
Phone: (619) 644-1111
Fax: (619) 644-1115
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY 5020 | California |
Profile Details
| NPI number | 1811928559 |
|---|---|
| LBN Legal business name | Mantell, Michael R. |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Feb 4th, 2011 - about 13 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 | 1811928559 | NPPES |
| California | Other | 2436992 | AETNA |
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