LARA DIA MANSOUR DO
NPI 1780264770
Student in an Organized Health Care Education/Training Program in Fontana, CA

Active since April 13, 2021PECOS EnrolledAccepts Medicare Assignment
17234 VALLEY BLVD, BUILDING A, FONTANA, CA 92335(833) 574-2273 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 3, 2023, Dec 8, 2021, May 6, 2021 and 1 more (4 updates tracked since 2021).

About Lara Dia Mansour Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LARA DIA MANSOUR DO (NPI 1780264770) is an individual student in an organized health care education/training program in Fontana, California and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of At Still Un Of Hlth Sciences, Col Of Osteo Med, Mesa (2020).

NPPES Registry Identity

NPI1780264770
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameLARA DIA MANSOURCredential: DO
Location Address17234 VALLEY BLVD, BUILDING AFontana, CA 92335-6720
Mailing Address17234 Valley Blvd, Building AFontana, CA 92335-6720
Sole ProprietorNo
Medical School CMSAt Still Un Of Hlth Sciences, Col Of Osteo Med, MesaGraduated 2020
Enumeration DateApril 13, 2021
Last NPPES UpdateAugust 2, 20234 updates tracked since enumeration
NPPES CertifiedAugust 2, 2023
NPI 1780264770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 20466 (CA)
17234 VALLEY BLVD, Fontana, CA 92335

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Lara Dia Mansour Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759742125
PECOS Enrollment IDI20250918001443
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
Psychiatry & Neurology (Psychiatry)
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Family Medicine
17234 VALLEY BLVD
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lara Mansour's NPI number?

The NPI number for Lara Mansour is 1780264770. It was assigned to this individual provider in the NPPES registry on April 13, 2021.

Where is Lara Mansour located?

Lara Mansour practices at 17234 Valley Blvd Building A, Fontana, CA 92335. The listed phone number is (833) 574-2273.

What is Lara Mansour's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Lara Mansour enrolled in Medicare?

Yes. Lara Mansour is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Lara Mansour was last updated on August 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.