Provider Demographics
NPI:1578672309
Name:MANDEL, DAN AVIEL (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:AVIEL
Last Name:MANDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1835 NEWPORT BLVD
Mailing Address - Street 2:A109-437
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-5031
Mailing Address - Country:US
Mailing Address - Phone:949-631-6500
Mailing Address - Fax:949-631-9700
Practice Address - Street 1:496 OLD NEWPORT BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4263
Practice Address - Country:US
Practice Address - Phone:949-631-6500
Practice Address - Fax:949-631-9700
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-02-10
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Provider Licenses
StateLicense IDTaxonomies
WAMD00045048207RR0500X
CAA88439207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology