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Contact Information

FRED AND MARY MANSUBI, M.D. A PROFESSIONAL MEDICAL CORPORATION
2577 SAMARITAN DR
SUITE 860
SAN JOSE, CA95124-4100
 Phone: 408-358-2627
 Fax: 408-356-6445
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Allergy/Immunology

2080P0201X 37 Physician/Pediatric Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for FRED AND MARY MANSUBI, M.D. A PROFESSIONAL MEDICAL CORPORATION

NPI Number 1114126034
LBN Legal business name FRED AND MARY MANSUBI, M.D. A PROFESSIONAL MEDICAL CORPORATION
Authorized official MEHRI (MARY) MANSUBI - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/11/2007
Last updated 03/06/2013 - About 13 years ago
Identifiers
CA License # A262890
CA License # A330510
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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