Provider Demographics
NPI:1356724637
Name:MANDELL, SEAN (PT)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:
Last Name:MANDELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 MISSION AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058
Mailing Address - Country:US
Mailing Address - Phone:760-585-4885
Mailing Address - Fax:760-585-1194
Practice Address - Street 1:3320 MISSION AVE
Practice Address - Street 2:SUITE H
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058
Practice Address - Country:US
Practice Address - Phone:760-585-4885
Practice Address - Fax:760-585-1194
Is Sole Proprietor?:No
Enumeration Date:2015-07-03
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT42125225100000X
CAPT42425225100000X
CA42125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist