Provider Demographics
NPI:1235543919
Name:MANGLA, SAISHO (DO)
Entity Type:Individual
Prefix:
First Name:SAISHO
Middle Name:
Last Name:MANGLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 S ALMA SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-7144
Mailing Address - Country:US
Mailing Address - Phone:480-668-1600
Mailing Address - Fax:480-668-1615
Practice Address - Street 1:1435 S ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-7144
Practice Address - Country:US
Practice Address - Phone:480-668-1600
Practice Address - Fax:480-668-1615
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ008045208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics