| Mani Mahdyoon, M.d., A Professional Corporation | |
|
845 S Fairmont Ave Suite #5 Lodi CA 95240-5113 | |
| (209) 366-2360 | |
| (209) 366-2352 |
| Full Name | Mani Mahdyoon, M.d., A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 845 S Fairmont Ave, Lodi, California |
| Authorized Official Name and Position | Mani Mahdyoon (PRESIDENT) |
| Authorized Official Contact | 2093662360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mani Mahdyoon, M.d., A Professional Corporation 845 S Fairmont Ave Suite #5 Lodi CA 95240-5113 Ph: (209) 366-2360 | Mani Mahdyoon, M.d., A Professional Corporation 845 S Fairmont Ave Suite #5 Lodi CA 95240-5113 Ph: (209) 366-2360 |
| NPI Number | 1467642900 |
|---|---|
| Provider Enumeration Date | 07/31/2007 |
| Last Update Date | 12/31/2015 |
| Medicare PECOS PAC ID | 9436195815 |
|---|---|
| Medicare Enrollment ID | O20050707000639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467642900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mani Mahdyoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144232349 PECOS PAC ID: 4688655806 Enrollment ID: I20040610000615 |
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