Provider Demographics
NPI:1518025923
Name:MANDOMETER INC.
Entity Type:Organization
Organization Name:MANDOMETER INC.
Other - Org Name:MANDOMETER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MALETZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-451-1008
Mailing Address - Street 1:11777 BERNARDO PLAZA CT
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2405
Mailing Address - Country:US
Mailing Address - Phone:858-451-1008
Mailing Address - Fax:858-451-0808
Practice Address - Street 1:11777 BERNARDO PLAZA CT
Practice Address - Street 2:SUITE 208
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2405
Practice Address - Country:US
Practice Address - Phone:858-451-1008
Practice Address - Fax:858-451-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)