Dr KELLY MICHELE MANDA is a female medical professional, specializing in Nurse Practitioner. She graduated in 2017.
MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF CALIFORNIA INC
2791 AGOURA RD
THOUSAND OAKS
CA
913613101
Tel: 8663892727
| Npi | 1134641087 |
| Pac Id | 1254697964 |
| Professional Enrollment Id | I20171114001351 |
| Last Name | MANDA |
| First Name | KELLY |
| Middle Name | MICHELE |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
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| Organization Legal Name | MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF CALIFORNIA INC |
| Group Practice Pac Id | 8224191374 |
| Number Of Group Practice Members | 76 |
| Line 1 Street Address | 2791 AGOURA RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | THOUSAND OAKS |
| State | CA |
| Zip Code | 913613101 |
| Phone Number | 8663892727 |
| Hospital Affiliation Ccn 1 | 050761 |
| Hospital Affiliation Lbn 1 | PROVIDENCE TARZANA MEDICAL CENTER |
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| Professional Accepts Medicare Assignment | Y |
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