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BENJAMIN REYES MANDAC MD NPI 1427014190


NPI Information

NPI: 1427014190
Provider Name: BENJAMIN REYES MANDAC, MD
Classification: Physical Medicine & Rehabilitation - 2081P0010X
Entity Type: Individual

Specialization: Pediatric Rehabilitation Medicine

PECOS Registration: Yes

Address:
710 LAWRENCE EXPY
SANTA CLARA, CA
ZIP 95051
Phone: (408) 851-9897
Get Directions

Benjamin Reyes Mandac, MD is a pediatric rehabilitation medicine physical medicine rehabilitation in Santa Clara, CA. The provider is a physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. Benjamin Reyes Mandac, MD NPI is 1427014190. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

710 LAWRENCE EXPY
SANTA CLARA, CA
ZIP 95051-173
Phone: (408) 851-9897
Fax: (408) 851-1199

The NPI 1427014190 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/21/2006 and was last updated on 2/11/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12081P0010XPhysical Medicine & RehabilitationPediatric Rehabilitation MedicineG55790CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G557900MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.