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MANSOUR MOFIDI, D.O.,INC
NPI 1902043193
Internal Medicine in La Mesa, CA

Active since January 09, 2009
5555 GROSSMONT CENTER DR, LA MESA, CA 91942(619) 770-0010(619) 425-5869 Get Directions Write a Review

NPPES record last updated: December 19, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mansour Mofidi, D.o.,inc NPPES

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

MANSOUR MOFIDI, D.O.,INC (NPI 1902043193) is a healthcare organization registered as an internal medicine in La Mesa, California and active in the NPI registry since January 2009. The organization lists Mansour Mofidi, President, as its authorized official.

NPPES Registry Identity

NPI1902043193
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMANSOUR MOFIDI, D.O.,INC
Location Address5555 GROSSMONT CENTER DRLa Mesa, CA 91942-3019
Mailing AddressPo Box 2303La Mesa, CA 91943-2303 · (619) 770-0010 · Fax (619) 425-5869
Phone(619) 770-0010
Fax(619) 425-5869
Organization SubpartNo
Authorized OfficialMansour MofidiPresident · (619) 770-0010
Enumeration DateJanuary 9, 2009
Last NPPES UpdateDecember 19, 2023
NPPES CertifiedDecember 19, 2023
✔ NPI 1902043193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A0A7485
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5555 GROSSMONT CENTER DR, La Mesa, CA 91942
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mansour Mofidi, D.o.,inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Mansour Mofidi, D.O.,inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Mansour Mofidi, DO
Internal Medicine
NPI 1164598843
5555 GROSSMONT CENTER DR
La Mesa, CA 91942
(619) 740-6000
✔ PECOSSame address
Edwin Jonathan Baluran, NP
Nurse Practitioner
NPI 1871308858
325 KEMPTON ST
Spring Valley, CA 91977
(619) 931-1110
✔ PECOS5.5 mi
Kellyann Knight, CRNP
Nurse Practitioner
NPI 1578882478
2400 E 4TH ST SUITE 65
National City, CA 91950
(619) 470-4321
✔ PECOS7.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mansour Mofidi, D.O.,inc's NPI number?

The NPI number for Mansour Mofidi, D.O.,inc is 1902043193. It was assigned to this organization in the NPPES registry on January 9, 2009.

Where is Mansour Mofidi, D.O.,inc located?

Mansour Mofidi, D.O.,inc is located at 5555 Grossmont Center Dr, La Mesa, CA 91942. The listed phone number is (619) 770-0010.

What is Mansour Mofidi, D.O.,inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mansour Mofidi, D.O.,inc enrolled in Medicare?

Yes. Mansour Mofidi, D.O.,inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mansour Mofidi, D.O.,inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Mansour Mofidi, D.O.,inc, in Internal Medicine and Nurse Practitioner. A 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 the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mansour Mofidi, D.O.,inc was last updated on December 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.