Harold R. Mancusi-Ungaro Jr., MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

G32831 Issued in CA

Practice address

3333 Mendocino Ave
Suite 130
Santa Rosa, CA 95403-2261

Phone

(707) 566-5288

Fax

(707) 566-5471

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1245382050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 MENDOCINO AVE",
            "address_2": "SUITE 130",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032261",
            "telephone_number": "707-566-5288",
            "fax_number": "707-566-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSI-UNGARO",
        "first_name": "HAROLD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G32831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G328310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kavita V. Mamtora, MD
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• Raquel Lynn Mancilla
• Sylvia Mancinas, LVN
• Dorothy Marie Mandel, PSYCHOLOGY LICENSE
• Crystal Mandujano Barajas
• Francesca Elena Manfredi, DO
• Heather Lilyann Manha
• Mark Anthony Legaspi Maningas

• Plastic Surgery Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.