Provider Demographics
NPI:1649211079
Name:MANSONHING, PAUL M (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:MANSONHING
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:4950 BARRANCA PKWY
Mailing Address - Street 2:STE 204
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4687
Mailing Address - Country:US
Mailing Address - Phone:949-726-1770
Mailing Address - Fax:949-726-1771
Practice Address - Street 1:4950 BARRANCA PKWY
Practice Address - Street 2:STE 204
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4687
Practice Address - Country:US
Practice Address - Phone:949-726-1770
Practice Address - Fax:949-726-1771
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2020-08-11
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Provider Licenses
StateLicense IDTaxonomies
CAA48928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48928Medicare ID - Type Unspecified