Davie Marvan Manullang

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95173934 Issued in CA

Practice address

1725 W 17TH St
Santa Ana, CA 92706-2316

Phone

(951) 858-7902

NPI assigned

Nov 20, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1316540263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 NELSON ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928810602",
            "telephone_number": "951-858-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927062316",
            "telephone_number": "951-858-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANULLANG",
        "first_name": "DAVIE",
        "middle_name": "MARVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95173934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nabil Mansour, PHARM D
• Wendy Champagne Mantecon
• Manuchehr M Darani MD Inc
• Clem-Ehros Manuel
• Jeffrey Manukian, ABAT
• Robert Manus II
• Sarahi Manzanares
• Yesenia Guadalupe Manzo-Meda, MSW
• Daniel Manzo
• Diana Manzo

• Registered Nurse in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.