Provider Demographics
NPI:1518072123
Name:MANN, PARAMJOT (MD)
Entity Type:Individual
Prefix:
First Name:PARAMJOT
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 TERMINO AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2128
Mailing Address - Country:US
Mailing Address - Phone:562-817-5602
Mailing Address - Fax:562-817-5605
Practice Address - Street 1:1703 TERMINO AVE STE 207
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2128
Practice Address - Country:US
Practice Address - Phone:562-817-5602
Practice Address - Fax:562-817-5605
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA80260OtherLICENSE NUMBER