Provider Demographics
NPI:1548453855
Name:MANSUBI, SHERWIN (ND)
Entity type:Individual
Prefix:DR
First Name:SHERWIN
Middle Name:
Last Name:MANSUBI
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15545 LOS GATOS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2567
Mailing Address - Country:US
Mailing Address - Phone:408-636-6762
Mailing Address - Fax:408-395-8889
Practice Address - Street 1:15545 LOS GATOS BLVD STE B
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2567
Practice Address - Country:US
Practice Address - Phone:408-636-6762
Practice Address - Fax:408-395-8889
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-24175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath