Individual provider · Type 1 NPI
Devery Mandagie, RN PHN
General Practice Registered Nurse · San Diego, CA
NPI number
1801927157
Active
Practice location
3851 Rosecrans St
San Diego, CA 92110-3115
Mailing address
2405 Chicago St
San Diego, CA 92110-4106
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Registered Nurse Primary | 163WG0000X | 556258 (CA) |
General Practice Registered Nurse: Definition to come...
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About NPI 1801927157
Devery Mandagie, RN PHN's National Provider Identifier is 1801927157, issued on Mar 8, 2007. The primary taxonomy on file is General Practice Registered Nurse (163WG0000X), and the practice location is in San Diego, CA. The record was last updated on Jul 8, 2007.