Organization Active NPI

Manjul Patwardhan M D Prof Corp

  • Family Medicine Physician
  • Cupertino, CA
National Provider Identifier
1336168426
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A69182 Issued in CA
Legal business name
MANJUL PATWARDHAN M D PROF CORP
Practice address
10353 Torre Ave
Ste a
Cupertino, CA 95014-3217
Phone
(408) 725-1777
NPI assigned
Jul 19, 2006
Last updated
Dec 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

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

Authorized official

Name
Manjul Patwardhan, MDNPI 1659398360
Title
Owner Physician
Phone
(408) 725-1777

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A69182 CA Primary

Addresses

Primary practice location

10353 Torre Ave
Ste a
Cupertino, CA 95014-3217

Mailing address

20472 Glasgow Dr
Saratoga, CA 95070-4326
Phone (408) 219-3130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080124000702 CA Part B Supplier - Clinic/Group Practice 2860574142 Receives reassigned benefits from 2 practitioners
Practice locations: Cupertino, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766534400000",
    "number": "1336168426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20472 GLASGOW DR",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704326",
            "telephone_number": "408-219-3130",
            "fax_number": "408-725-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10353 TORRE AVE",
            "address_2": "STE A",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143217",
            "telephone_number": "408-725-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANJUL PATWARDHAN M D PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A",
        "authorized_official_last_name": "PATWARDHAN",
        "authorized_official_first_name": "MANJUL",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "408-725-1777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A69182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2025; 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.