Individual provider Active NPI

Brian Michael Manjarres, M.D.

  • Internal Medicine Physician
  • Rancho Mirage, CA
National Provider Identifier
1023218203
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A100304 Issued in CA
Practice address
36101 Bob Hope Dr
Ste B-2
Rancho Mirage, CA 92270-2001
Phone
(760) 321-1315
Fax
(760) 321-1094
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A100304 CA Primary

Addresses

Primary practice location

36101 Bob Hope Dr
Ste B-2
Rancho Mirage, CA 92270-2001

Mailing address

2615 Lincoln Ave
San Diego, CA 92104-2817
Phone (760) 321-1315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1023218203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 LINCOLN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042817",
            "telephone_number": "760-321-1315",
            "fax_number": "760-321-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36101 BOB HOPE DR",
            "address_2": "STE B-2",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702001",
            "telephone_number": "760-321-1315",
            "fax_number": "760-321-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANJARRES",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A100304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.