Provider Demographics
NPI:1922394782
Name:MANGIAPANE, MARK RYAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:RYAN
Last Name:MANGIAPANE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2200 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2004
Mailing Address - Country:US
Mailing Address - Phone:209-250-2683
Mailing Address - Fax:209-250-2684
Practice Address - Street 1:2200 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2004
Practice Address - Country:US
Practice Address - Phone:209-250-2683
Practice Address - Fax:209-250-2684
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2020-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A16246207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine