Provider Demographics
NPI:1306077342
Name:BINNING, MANDIP (NP)
Entity type:Individual
Prefix:
First Name:MANDIP
Middle Name:
Last Name:BINNING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 LEGEND CIR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8693
Mailing Address - Country:US
Mailing Address - Phone:707-410-9701
Mailing Address - Fax:
Practice Address - Street 1:2185 PACHECO ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2309
Practice Address - Country:US
Practice Address - Phone:925-676-0505
Practice Address - Fax:925-676-2814
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17468363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health