Dr Tito K Mantilla, MD | |
5501 Old York Rd Ste 1, Philadelphia, PA 19141 | |
(215) 456-7890 | |
Not Available |
Full Name | Dr Tito K Mantilla |
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Gender | Male |
Speciality | Family Medicine |
Location | 5501 Old York Rd Ste 1, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1205498318 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | MD478971 (Pennsylvania) | Primary |
Entity Name | Fornance Physician Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053363523 PECOS PAC ID: 8527962661 Enrollment ID: O20040216000037 |
Mailing Address | Practice Location Address |
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Dr Tito K Mantilla, MD 5501 Old York Rd Ste 1, Philadelphia, PA 19141-3098 Ph: () - | Dr Tito K Mantilla, MD 5501 Old York Rd Ste 1, Philadelphia, PA 19141 Ph: (215) 456-7890 |
Srikar Vegesna, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2118 Cottman Ave, Philadelphia, PA 19149 Phone: 215-342-3020 Fax: 215-342-3653 | |
Chelsea Tiffany Salas-tam, Family Medicine Medicare: Medicare Enrolled Practice Location: 833 Chestnut St Ste 301, Philadelphia, PA 19107 Phone: 215-955-7190 | |
Meng-chao Lee, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7500 Central Ave Ste 104, Philadelphia, PA 19111 Phone: 215-742-0712 Fax: 215-742-5218 | |
Carol Bowes-lawlor, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 33 E Chestnut Hill Ave, Philadelphia, PA 19118 Phone: 215-753-9080 Fax: 215-753-8830 | |
Dr. Seung Hee Hong, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2301 E Allegheny Ave, Suite 150, Philadelphia, PA 19134 Phone: 215-926-3535 Fax: 215-926-3536 | |
Dr. Denise Hamilton Christian, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 251 E Bringhurst St, Philadelphia, PA 19144 Phone: 215-844-1020 Fax: 215-844-8147 | |
Mara Leyzin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8025 Castor Ave, Philadelphia, PA 19152 Phone: 215-745-9900 Fax: 215-745-9902 |