| Jessica Mantilla MD Inc | |
|
100 S Raymond Ave Alhambra CA 91801-3166 | |
| (951) 929-6260 | |
| (951) 765-2855 |
| Full Name | Jessica Mantilla MD Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 S Raymond Ave, Alhambra, California |
| Authorized Official Name and Position | Jessica P Mantilla (PRESIDENT) |
| Authorized Official Contact | 9519296260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Mantilla MD Inc Po Box 788 Hemet CA 92546-0788 Ph: (951) 929-6260 | Jessica Mantilla MD Inc 100 S Raymond Ave Alhambra CA 91801-3166 Ph: (951) 929-6260 |
| NPI Number | 1861841348 |
|---|---|
| Provider Enumeration Date | 06/06/2016 |
| Last Update Date | 06/06/2016 |
| Medicare PECOS PAC ID | 0941595094 |
|---|---|
| Medicare Enrollment ID | O20160829000970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861841348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | A110850 (California) | Primary |
| Provider Name | Jessica Patricia Mantilla |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891957973 PECOS PAC ID: 0143462150 Enrollment ID: I20130803000147 |
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