Manzana Family Medicine LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MANZANA FAMILY MEDICINE LLC

Practice address

2410 Commerce TRL
Imperial, CA 92251-4003

Phone

(760) 332-8688

NPI assigned

Aug 3, 2020

Organization subpart

No

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

Authorized official

Name

Mari Carlo Bicierro Manzana, MDNPI 1063946341

Title

Ceo

Phone

(661) 714-1560

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mari Carlo Manzana

  • Family Medicine Physician
  • Indio, CA
  • NPI 1063946341
  NPD Authorized official

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1093325375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922510066",
            "telephone_number": "661-714-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 COMMERCE TRL",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922514003",
            "telephone_number": "760-332-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANZANA FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "MANZANA",
        "authorized_official_first_name": "MARI CARLO",
        "authorized_official_middle_name": "BICIERRO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-714-1560",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Llamas
• Ray Mun Loo, M.D
• Lizbeth Lopez
• Danielle Madrigal
• Raul Alex Mancilla, O.D.
• Mari Carlo Manzana, M.D., Inc.
• Stacie Ann Martin, APRN
• Tyler Sanga Martin, NP
• Carlos Martinez Calderon, DDS
• Kameron Martinez

• Clinic/Center in Imperial, CA
• Providers in Imperial, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.