Organization Active NPI

Sunny Mann MD Inc

  • Addiction Medicine (Family Medicine) Physician
  • Stockton, CA
National Provider Identifier
1104609122
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
SUNNY MANN MD INC
Practice address
2216 N California St Ste a
Stockton, CA 95204-5533
Phone
(209) 851-2065
Fax
(209) 292-8910
NPI assigned
Aug 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Dr. Sandeep Mann, MDNPI 1033671672
Title
Owner
Phone
(209) 851-2065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

2216 N California St Ste a
Stockton, CA 95204-5533

Mailing address

2216 N California St Ste a
Stockton, CA 95204-5533
Phone (209) 851-2065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230907002362 CA Part B Supplier - Clinic/Group Practice 3971967068 Receives reassigned benefits from 1 practitioner
Practice locations: Stockton, CA

National Provider Directory

National Provider Directory

Locations

2216 N California St
Ste A
Stockton, CA 95204
Phone (209) 851-2065

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1104609122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 N CALIFORNIA ST STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045533",
            "telephone_number": "209-851-2065",
            "fax_number": "209-292-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 N CALIFORNIA ST STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045533",
            "telephone_number": "209-851-2065",
            "fax_number": "209-292-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNY MANN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-15",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-851-2065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.