Provider Demographics
NPI:1326052853
Name:STEVEN K. MANGAR, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:STEVEN K. MANGAR, M.D., A MEDICAL CORPORATION
Other - Org Name:STEVEN K. MANGAR, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:MANGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-751-3334
Mailing Address - Street 1:PO BOX 1530
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93902-1530
Mailing Address - Country:US
Mailing Address - Phone:831-751-3334
Mailing Address - Fax:831-751-3339
Practice Address - Street 1:680 E ROMIE LN STE B
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4206
Practice Address - Country:US
Practice Address - Phone:831-751-3334
Practice Address - Fax:831-751-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65476174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH47735Medicare UPIN