Basic Information
| Provider Information | |||||||||
| NPI: | 1285669267 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MANDEL | ||||||||
| FirstName: | HILARY | ||||||||
| MiddleName: | DIAMOND | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11728 DOROTHY ST | ||||||||
| Address2: | APT. 202 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900495560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136690582 | ||||||||
| FaxNumber: | 9137890914 | ||||||||
| Practice Location | |||||||||
| Address1: | 16111 PLUMMER ST. | ||||||||
| Address2: | |||||||||
| City: | SEPULVEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188917711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 07/13/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 190475 | NY | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | D0063455 | MD | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 04-27711 | KS | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 117321 | MO | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 59585 | NJ | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | G87885 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | IL | N | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.