DR. VIJAY MANDYAM (NPI# 1174618672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174618672 |
| Entity Type | Individual |
| Full Name | DR. VIJAY MANDYAM |
| Credential | DPM |
| Practice Address |
43713 20th St W Ste 3 Lancaster CA 93534-4628 |
| Practice Telephone | 6619458700 |
| Practice Fax Number | 6619458757 |
| Mailing Telephone | 6619458700 |
| Mailing Fax Number | 6619458757 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-06-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | E4071 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 000E40711 | 05 |
| Street Address |
43713 20TH ST W STE 3 |
| City | LANCASTER |
| State | CA |
| Zip Code | 93534-4628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306884648 | Beverly Radiology Medical Group | Radiology | 43713 20th St W, Lancaster, CA 93534-4628 | 2006-06-02 |
| 1043606528 | Access Imaging, LLC | Clinic/Center | 43713 20th St W, 1, Lancaster, CA 93534-4628 | 2015-04-10 |
| 1851708465 | Therapeutic Time Inc. | Psychologist | 43713 20th St W, Suite 5, Lancaster, CA 93534-4628 | 2014-07-15 |
| 1386843886 | Ralph B Waugh Dds Md Inc | Surgery | 43713 20th St W, #1, Lancaster, CA 93534 | 2007-07-13 |
| 1689793457 | Carol Ann Chambers | Counselor | 43713 20th St W, Suite 5, Lancaster, CA 93534-4628 | 2007-03-29 |
| 1508997909 | Trisha Lee Rich-thurm | Psychologist | 43713 20th St W, Suite E, Lancaster, CA 93534-4628 | 2007-03-08 |
| 1619074424 | Dr Patrick M Paige Dds Inc | Dentist | 43713 20th St W, #5, Lancaster, CA 93534-4628 | 2006-09-20 |
| 1306942388 | Robert L Howard | Counselor | 43713 20th St W, Ste 5, Lancaster, CA 93534-4628 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346098 | Lori Ann Barlow Washington | Counselor | 921 W J Street, Lancaster, CA 93534 | 2020-05-01 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1124668470 | Latonya Jean Allen | Case Manager/Care Coordinator | 44443 10th St. West, Lancaster, CA 93534 | 2020-01-14 |
| 1629629746 | Korinna Fite | Occupational Therapy Assistant | 43860 10th St. W., Lancaster, CA 93534 | 2019-09-20 |
| 1114576105 | Victor Nemr Hass Md | Anesthesiology | Embassy Surgery Center, 42135 10th Street West 325, Lancaster, CA 93534 | 2019-09-11 |
| 1609421007 | Jaime A Mort | Nurse Practitioner | 43112 N 15st W, Lancaster, CA 93534 | 2019-08-03 |
| 1013560747 | Allyson Lods | Dietitian, Registered | 43115 15th Street West, Lancaster, CA 93534 | 2019-07-22 |
| 1144884123 | Nicole Breanne Palman | Speech-Language Pathologist | 43860 10th St. West, 1st Floor, Lancaster, CA 93534 | 2019-04-25 |
| 1841761475 | Vanessa Gonzalez | Case Manager/Care Coordinator | 44226 10th St West, Lancaster, CA 93534 | 2018-12-07 |
| 1760969265 | Marilyn Joy Pollack | Physical Therapy Assistant | 1306 W Avenue J Ste 2, Lancaster, CA 93534 | 2018-07-26 |
| Find all providers in zip 93534 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790160901 | Lancaster Medical Group, LLC | Podiatrist | 90 Good Dr Ste 101, Lancaster, PA 17603-4360 | 2015-07-29 |
| 1639484991 | Astrid Avis | Podiatrist | 45 E Orange St, Lower Level, Lancaster, PA 17602-5123 | 2010-08-11 |
| 1487832119 | Lancaster Depew Podiatry Grp | Podiatrist | 5429 Broadway St, Lancaster, NY 14086-2123 | 2008-02-05 |
| 1003097569 | Peter C Smith Dpm | Podiatrist | 300 Granite Run Dr, Suite 160, Lancaster, PA 17601-6806 | 2007-11-26 |
| 1134317555 | Mj6 Enterprises | Podiatrist | 996 E Orange St, Lancaster, PA 17602-3214 | 2007-10-10 |
| 1891846218 | Robert Joseph Rudewicz | Podiatrist | 5429 Broadway, Lancaster, NY 14086-2123 | 2007-01-13 |
| 1831260934 | Steven A Jacobs | Podiatrist | 11 E Walnut St, Lancaster, PA 17602-4923 | 2006-11-11 |
| 1679663074 | Lawrence H Rosen | Podiatrist | 24 E Mcgovern Ave, Lancaster, PA 17602-1923 | 2006-10-14 |
| 1245326271 | Andrew J Heller | Podiatrist | 1505 W Ave J, # 203, Lancaster, CA 93534 | 2006-10-05 |
| 1518930817 | Brandon Scot Percival | Podiatrist | 1190 Highway 9 Byp W, Lancaster, SC 29720-1709 | 2006-02-08 |
| Find all providers in LANCASTER | ||||
Please comment or provide details below to improve the information on DR. VIJAY MANDYAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.