Provider Demographics
NPI:1902221674
Name:MENTEER INTERNAL MEDICINE, INC.
Entity Type:Organization
Organization Name:MENTEER INTERNAL MEDICINE, INC.
Other - Org Name:MDVIP-FRANCOISE G. MENTEER, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCOISE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MENTEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-854-6855
Mailing Address - Street 1:23320 PARK HACIENDA
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1715
Mailing Address - Country:US
Mailing Address - Phone:818-854-6855
Mailing Address - Fax:805-494-9152
Practice Address - Street 1:227 W JANSS RD
Practice Address - Street 2:SUITE 305
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1848
Practice Address - Country:US
Practice Address - Phone:805-449-4181
Practice Address - Fax:805-494-9152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87264207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH13876Medicare UPIN