Provider Demographics
NPI:1982799813
Name:MANN, RUPINDER (M D INC)
Entity Type:Individual
Prefix:
First Name:RUPINDER
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:M D INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72047 DINAH SHORE DR
Mailing Address - Street 2:SUITE C4
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1790
Mailing Address - Country:US
Mailing Address - Phone:760-770-7600
Mailing Address - Fax:760-770-0500
Practice Address - Street 1:72047 DINAH SHORE DRIVE
Practice Address - Street 2:SUITE C4
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1790
Practice Address - Country:US
Practice Address - Phone:760-770-7600
Practice Address - Fax:760-770-0500
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA066357207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A663570Medicaid
CA00A663570Medicaid