National Provider Identifier Database

KATHERINE A MANDEVILLE, MD – NPI #1649355397
Pediatric Emergency Medicine

A pediatrician who has special qualifications to manage emergencies in infants and children.


Contact Information

KATHERINE A MANDEVILLE, MD
3020 CHILDRENS WAY
SAN DIEGO, CA92123-4223
Phone: 858-966-8036
Fax: 858-966-7433
Website:
Specialty Taxonomy Code
* Pediatric Emergency Medicine 2080P0204X
Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for KATHERINE A MANDEVILLE

NPI Number 1649355397
Credentials MD
Entity Individual
Enumeration date 10/25/2006
Last updated 07/21/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • CA License #: C149595
  • CO Medicaid: 22807349
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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