Individual provider Active NPI

Anthony Mannarino, MD

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1003493917
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A182604 Issued in CA
Practice address
4647 Zion Ave Ste 1116
San Diego, CA 92120-2507
Phone
(442) 385-7000
NPI assigned
Mar 26, 2021
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A182604 CA Primary

Addresses

Primary practice location

4647 Zion Ave Ste 1116
San Diego, CA 92120-2507

Mailing address

4647 Zion Ave Ste 1116
San Diego, CA 92120-2507

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230919000494 CA Practitioner - Emergency MedicinePractitioner - Family Practice 2961866322 Reassigns benefits to 1 organization
I20240622000307 AZ Practitioner - Emergency Medicine 2961866322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York Medical College, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Estrellas Emergency Physicians LLCGroup PAC ID 5193002954, 38 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A182604CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jul 25, 2023 Accepting new patients
Sierra Estrellas Emergency Physicians LLC Emergency Medicine CurrentSince May 12, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 25, 2023 Accepting new patients

Locations

1500 S Mill Ave
Tempe, AZ 85281
Phone (480) 784-5500

11351 S Frontage Rd
Yuma, AZ 85367
Phone (928) 336-2000

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

4647 Zion Ave
Ste 1116
San Diego, CA 92120
Phone (619) 385-6263

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2930

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1003493917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE STE 1116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE STE 1116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507",
            "telephone_number": "442-385-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNARINO",
        "first_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A182604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.