Active NPI
Manveer Hundal
- Medical Physician Assistant
- San Ramon, CA
National Provider Identifier
1275280224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA64836
- Practice address
- 1081 Market PL Ste 500
San Ramon, CA 94583-4750 - Phone
- (669) 235-4188
- Fax
- (669) 235-4221
- NPI assigned
- Mar 9, 2022
- Last updated
- Nov 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA64836 | CA | Primary |
Addresses
Primary practice location
1081 Market PL Ste 500
San Ramon, CA 94583-4750
Mailing address
1310 Club Dr
Vallejo, CA 94592-1187
Phone (707) 638-5200
Other practice location 1
175 N Jackson Ave Ste 202
San Jose, CA 95116-1909
Phone (669) 235-4188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64836 | CA | MD | Pharmacist |
| PA64836 | CA | MD | Medical Physician Assistant |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Neurology Physician
- San Jose, CA
- NPI 1700276177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1275280224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 CLUB DR",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945921187",
"telephone_number": "707-638-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1081 MARKET PL STE 500",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945834750",
"telephone_number": "669-235-4188",
"fax_number": "669-235-4221"
}
],
"practiceLocations": [
{
"address_1": "175 N Jackson Ave Ste 202",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "951161909",
"country_code": "US",
"telephone_number": "669-235-4188",
"fax_number": "669-235-4221",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUNDAL",
"first_name": "MANVEER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-09",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA64836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.