Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lee Chaidez Mancilla, PA-C

Individual provider Physician Assistant · NPI 1356526495

Lee Chaidez Mancilla, PA-C is a Physician Assistant in Santa Monica, California. Licensed in California. Registered with an NPI since 2008.

Licensed in
CA
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1711 Ocean Park Blvd
Santa Monica, CA 90405-4901
Phone: (310) 450-4773
Fax: (310) 450-0873
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA19534 (CA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 19534 (CA)

Record details

NPI number1356526495
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 8, 2008
Last updated in NPPESAugust 17, 2010

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