Provider Demographics
NPI:1891112223
Name:MADANI, MONA (MD)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:MADANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:23326 HAWTHORNE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3757
Mailing Address - Country:US
Mailing Address - Phone:310-257-7232
Mailing Address - Fax:424-212-5076
Practice Address - Street 1:2110 E. EL SEGUNDO BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245
Practice Address - Country:US
Practice Address - Phone:310-517-7030
Practice Address - Fax:310-893-0248
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2022-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ54031207Q00000X
CAA171558207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine