Search › California › 363A00000X
Lee Mancilla, PA-C
NPI 1356526495 · on the registry since 2008
Practice
- Address
- 1711 Ocean Park Blvd
Santa Monica, CA 90405 - Phone
- (310) 450-4773
- Fax
- (310) 450-0873
- Clinicians at this address
- 11
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363AM0700X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-08-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California