| Dr Mehrdad Ali Mansouri, MD, PHD | |
|
2500 Alhambra Ave, Martinez, CA 94553-3156 | |
| (925) 370-5200 | |
| Not Available |
| Full Name | Dr Mehrdad Ali Mansouri |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Location | 2500 Alhambra Ave, Martinez, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376532747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | A101584 (California) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Entity Name | John Muir Physician Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841407665 PECOS PAC ID: 6608789813 Enrollment ID: O20031226000143 |
| Entity Name | Providence Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mehrdad Ali Mansouri, MD, PHD 528 Clyne Ct, Benicia, CA 94510-3842 Ph: (707) 365-7039 | Dr Mehrdad Ali Mansouri, MD, PHD 2500 Alhambra Ave, Martinez, CA 94553-3156 Ph: (925) 370-5200 |
Jennifer Stanziale, MD Hospitalist Medicare: Medicare Enrolled Practice Location: 2500 Alhambra Ave, Martinez, CA 94553 Phone: 925-370-5200 | |
Maxwell Logan Binstock, MD, MS Hospitalist Medicare: Medicare Enrolled Practice Location: 2500 Alhambra Ave, Martinez, CA 94553 Phone: 925-370-5000 |