Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | A83245 | CA |
NPI | 1083695605 |
---|---|
Provider Name | Rebecca Whitney Mandel |
First Address | Valencia, CA 91355-4011 |
Second Address | Valencia, CA 91355-4011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 08/07/2007 |