LARA DIA MANSOUR DO
NPI 1780264770
Student in an Organized Health Care Education/Training Program in Fontana, CA
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
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Lara Mansour reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Altos, CA 94022
- Reassigned Medicare billing, California enrollment
- 19 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
FONTANA, CA 92335
FONTANA, CA 92335
FONTANA, CA 92335
FONTANA, CA 92335
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.
Which organization bills Medicare for Lara Mansour's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lara Mansour reassigns Medicare benefits to Integrative Behavioral Health & Medicine, Inc. (Los Altos, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lara Mansour's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Lara Dia Mansour, DO · NPI 1780264770
Student in an Organized Health Care Education/Training Program provider in Fontana, California. Individual provider, active in the CMS NPPES registry since April 13, 2021.
## Identity
- **NPI:** 1780264770 (Entity type: Individual)
- **Enumerated:** April 13, 2021
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 17234 VALLEY BLVD, BUILDING A, Fontana, CA 92335-6720
- **Phone:** (833) 574-2273
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Integrative Behavioral Health & Medicine, Inc. (NPI 1548910151, Los Altos, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** At Still Un Of Hlth Sciences, Col Of Osteo Med, Mesa, class of 2020
## Record status
- **NPPES last updated:** August 2, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1780264770) · Data from the CMS NPPES public registry.