Provider Demographics
NPI:1457433542
Name:MANN, ALISON METHERELL (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:METHERELL
Last Name:MANN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:KAREN
Other - Last Name:METHERELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1813
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-4813
Mailing Address - Country:US
Mailing Address - Phone:657-241-3600
Mailing Address - Fax:657-241-7708
Practice Address - Street 1:1190 W. BAKER STREET STE 103
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626
Practice Address - Country:US
Practice Address - Phone:714-668-2525
Practice Address - Fax:714-668-2530
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73789208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics