DR. VIJAY MANDYAM (NPI# 1619456704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619456704 |
| Entity Type | Organization |
| Organization Name | DR. VIJAY MANDYAM |
| 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 | 2018-08-09 |
| Last Update Date | 2018-08-09 |
| Authorized Official Name | DR. VIJAY MANDYAM (OWNER) |
| Authorized Official Telephone | 8185993997 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP1100X |
Clinic/Center Specialization: Podiatric |
E4071 | CA | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18856 Roscoe Blvd Ste B, Northridge, CA 913246301 | 8189043338 | 6619458757 |
| Street Address |
43713 20TH ST W STE 3 |
| City | LANCASTER |
| State | CA |
| Zip Code | 93534-4628 |
| 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 | 261QP1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Podiatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316988819 | Larry A Bell Dpm | Clinic/Center | 2112 Harrisburg Pike, Suite 1, Lancaster, PA 17604-3200 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811519515 | Collins Podiatry Corporation | Clinic/Center | 1223 Grant Ave Ste D, Novato, CA 94945-3157 | 2020-05-15 |
| 1427683523 | Inderjeet Bhamra Dpm PC | Clinic/Center | 2685 Hesselbein Way, San Jose, CA 95148-2515 | 2020-03-09 |
| 1073159794 | Jafary Foot & Ankle Specialists Inc | Clinic/Center | 4706 Sepulveda Blvd Apt 202, Sherman Oaks, CA 91403-2478 | 2019-11-19 |
| 1154882678 | Philip S Schauweker D.p.m. Professional Podiatric Medicine Corporation | Clinic/Center | 1043 Elm Ave Ste 407, Long Beach, CA 90813-3206 | 2019-03-27 |
| 1730676958 | Claire E. Futenma, Dpm, Inc. | Clinic/Center | 131 N El Molino Ave Ste 230, Pasadena, CA 91101-1877 | 2018-04-13 |
| 1598265431 | Zargar Podiatry Inc | Clinic/Center | 370 Elan Village Ln Unit 321, San Jose, CA 95134-2535 | 2018-02-16 |
| 1255847638 | Szm Medical Corp | Clinic/Center | 1687 Erringer Rd Ste 206, Simi Valley, CA 93065-6509 | 2017-12-20 |
| 1134630981 | Huntington Foot & Ankle Care, Inc. | Clinic/Center | 18682 Beach Blvd Ste 140, Huntington Beach, CA 92648-2050 | 2017-10-19 |
| 1023485422 | Steven F Kaplan Dpm A Professional Podiatric Corporation Inc. | Clinic/Center | 404 W Baseline Rd, Glendora, CA 91740-4801 | 2015-09-01 |
| 1467829002 | Criag Morgan | Clinic/Center | 500 E. Remington Dr. Ste 29, Sunnyvale, CA 94087 | 2015-08-31 |
| Find all providers with the same taxonomy | ||||
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| 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.