| Doctor Name: | MR. GARY FREDERICK MANDILE |
| NPI Number: | 1225252018 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CCP |
| License Number: | |
| Business Practice Address: | 5801 S Mcclintock Dr Suite 110 Tempe, AZ - 852836002 |
| Business Phone Number: | 4807770607 |
| Business Fax Number: | |
| Mailing Address: | Po Box 27341, TEMPE |
| State: | AZ |
| Postal Code: | 852857341 |
| Phone Number: | 4807770607 |
| Fax Number: | 6024807771 |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 04/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 242T00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Perfusionist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient |