Organization Active NPI

Maria C. Manalo M.D., P.C.

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1043481153
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
11659 Issued in NV
Legal business name
MARIA C. MANALO M.D., P.C.
Practice address
8775 West Deer Springs Way
Las Vegas, NV 89149-4409
Phone
(702) 658-9874
Fax
(702) 658-9874
NPI assigned
Mar 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Maria Christina Manalo, M.D.
Title
Owner
Phone
(702) 658-9874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 11659 NV Primary

Addresses

Primary practice location

8775 West Deer Springs Way
Las Vegas, NV 89149-4409

Mailing address

2711 N Tenaya Way
Suite 104
Las Vegas, NV 89128
Phone (702) 658-9874

Other identifiers 2

IdentifierTypeStateIssuer
11659OtherNVMEDICAL LICENSE
193620OtherNVAM BOARD OF INTERNAL MEDI

National Provider Directory

National Provider Directory

Locations

3100 W Charleston Blvd
Ste 202
Las Vegas, NV 89102
Phone (702) 471-7779

2711 N Tenaya Way
Ste 104
Las Vegas, NV 89128

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1043481153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 N TENAYA WAY",
            "address_2": "SUITE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89128",
            "telephone_number": "702-658-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8775 WEST DEER SPRINGS WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494409",
            "telephone_number": "702-658-9874",
            "fax_number": "702-658-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA C. MANALO M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MANALO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "CHRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-658-9874",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NV",
            "license": "11659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "11659",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AM BOARD OF INTERNAL MEDI",
            "identifier": "193620",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.