Individual provider Active NPI

Rhodel Matthew Manzano, DC, ATC

  • Chiropractor
  • Santa Clarita, CA
National Provider Identifier
1043896152
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC36053 Issued in CA
Practice address
25000 Avenue Stanford Ste 161
Santa Clarita, CA 91355-4594
Phone
(661) 753-3090
Fax
(833) 563-2545
NPI assigned
Mar 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC36053 CA Primary

Addresses

Primary practice location

25000 Avenue Stanford Ste 161
Santa Clarita, CA 91355-4594

Mailing address

23949 Rustico CT
Santa Clarita, CA 91354-1559
Phone (661) 877-0429

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

State licenses

LicenseStateTypeSpecialty
DC36053CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1043896152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23949 RUSTICO CT",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913541559",
            "telephone_number": "661-877-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25000 AVENUE STANFORD STE 161",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913554594",
            "telephone_number": "661-753-3090",
            "fax_number": "833-563-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "RHODEL",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DC, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.