Provider Demographics
NPI:1144596305
Name:MANDELL, ARNOLD JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:JOSEPH
Last Name:MANDELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:230 PROSPECT ST
Mailing Address - Street 2:#33
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4646
Mailing Address - Country:US
Mailing Address - Phone:828-301-1478
Mailing Address - Fax:828-254-4431
Practice Address - Street 1:230 PROSPECT ST
Practice Address - Street 2:#33
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4646
Practice Address - Country:US
Practice Address - Phone:828-301-1478
Practice Address - Fax:828-254-4431
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC213332084P0800X
FLME00084242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry