Active NPI
Ejon Lee Mannil
- Student in an Organized Health Care Education/Training Program
- Alhambra, CA
National Provider Identifier
1316786973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1000 S. Fremont Ave.
Unit 7, BLDG. A10, Ste. N10100, RM 11150
Alhambra, CA 91803 - Phone
- (626) 457-4240
- NPI assigned
- May 23, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1000 S. Fremont Ave.
Unit 7, BLDG. A10, Ste. N10100, RM 11150
Alhambra, CA 91803
Mailing address
20970 Rambling Rd.
Apple Valley, CA 92308
Phone (951) 318-4560
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1316786973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20970 RAMBLING RD.",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "92308",
"telephone_number": "951-318-4560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S. FREMONT AVE.",
"address_2": "UNIT 7, BLDG. A10, STE. N10100, RM 11150",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "91803",
"telephone_number": "626-457-4240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNIL",
"first_name": "EJON",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-23",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alhambra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.