MAMIE MUKUNDI MANDELA


Address: 1413 E 218th St, Carson, CA 90745-2402
Phone: 3107025392

MAMIE MUKUNDI MANDELA (NPI# 1831661370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1831661370
Entity Type Individual
Full Name MAMIE MUKUNDI MANDELA
Credential NURSE PRACTITIONER
Practice Address 1413 E 218th St
Carson
CA 90745-2402
Practice Telephone 3107025392
Practice Fax Number 3105182585
Mailing Telephone 3107025392
Mailing Fax Number 3105182585
Enumeration Date 2018-12-21
Last Update Date 2019-06-14
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner 95010871 CA Physician Assistants & Advanced Practice Nursing Providers
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
95010871 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1413 E 218TH ST
City CARSON
State CA
Zip Code 90745-2402

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336787696 Michael Yoshio Sujishi Technician/Technologist 150 West Carson Street, Store 8839, Carson, CA 90745 2019-12-18
1891269262 Cesar Carrasco Dds Inc Dentist 21847 S Avalon Blvd, Carson, CA 90745 2019-01-18
1427557305 Stephanie Yunjung Ha Nurse Practitioner 23517 S. Main St., Carson, CA 90745 2018-02-06
1861911125 Maria C Aluning Dentist 242 W. Carson St., Carson, CA 90745 2017-09-18
1144676024 Omid Barkhordar Dental Corporation Dentist 101 West Carson Street, Carson, CA 90745 2016-05-10
1255720652 Sandy Mauricio Physical Therapy Assistant 1804 E 215th St, Carson, CA 90745 2015-01-22
1275948994 United Urgent Care and Wellness Center, Inc. Clinic/Center 522 West Carson Street, Carson, CA 90745 2014-06-23
1184052805 Jumana B Hanna Pharmacist 500 Carson Town Center Kmart 4987 Pharmacy, Carson, CA 90745 2013-10-15
1679912422 David J Chon Dentist 612 E Carson St #101, Carson, CA 90745 2013-06-14
1942644133 Seema M Dave Optometrist 150 W Carson Street, Cvs Optical, Carson, CA 90745 2013-04-18
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871931741 Integrated Medical Group Inc Nurse Practitioner 208 E Carson St Ste 101, Carson, CA 90745-2762 2013-06-12
1245757699 Jaimie T Abraham Nurse Practitioner 522 W Carson St, Carson, CA 90745-2635 2017-08-26
1093259558 Leslie Ann Reyes Espe Nurse Practitioner 1000 E Dominguez St, Suite 110, Carson, CA 90746-3600 2016-12-16
1750710950 Lilian Nkiru Ndukwe Nurse Practitioner 454 E Carson Plaza Dr, Suite 209, Carson, CA 90746-3209 2013-11-07

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NPI Name Taxonomy Address Enumeration
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1710584008 Venessa Beck Nurse Practitioner 903 Cardiff St, San Diego, CA 92114-5019 2020-10-08
1053918094 Janel Nicole Sanglerat Nurse Practitioner 416 Aviation Blvd, Santa Rosa, CA 95403-1032 2020-10-02
1790382760 Christopher Tran Nurse Practitioner 11441 Heacock St Ste F, Moreno Valley, CA 92557-7907 2020-10-02
1487266292 Mollie Shira Hudson Nurse Practitioner 14 Whitmore Pl Apt 15, Oakland, CA 94611-4635 2020-08-21
1962014381 Mario Javier Herrera Nurse Practitioner 2130 High Pointe Dr, Apt 108, Corona, CA 92879 2020-08-18
1952912131 Norman Ivan Kier Nurse Practitioner 3834 Edison Ave, Sacramento, CA 95821-2728 2020-08-12
1942811377 Thanhan Mathews Nurse Practitioner 114 W Cameron St Apt B, Hanford, CA 93230-2965 2020-08-10
1972113355 Marine Mary Kademyan Nurse Practitioner 6528 Babcock Ave, North Hollywood, CA 91606 2020-07-31
1245849645 Shannon Pereira Nurse Practitioner 2368 Honeysuckle Way, Hemet, CA 92545-4796 2020-07-31
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Competitor

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City CARSON
Zip Code 90745

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Dataset Information

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.

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