Provider Demographics
NPI:1821060724
Name:SCHOELLERMAN, MANAL MOSAAD (MD)
Entity Type:Individual
Prefix:
First Name:MANAL
Middle Name:MOSAAD
Last Name:SCHOELLERMAN
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 1:13280 EVENING CREEK DR S
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4101
Mailing Address - Country:US
Mailing Address - Phone:858-546-3800
Mailing Address - Fax:858-546-3900
Practice Address - Street 1:13280 EVENING CREEK DR S
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4101
Practice Address - Country:US
Practice Address - Phone:858-546-3800
Practice Address - Fax:858-546-3900
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA686832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A686830Medicaid
CA00A686830Medicaid
CA00A686830Medicaid