Individual provider Active NPI

Lincoln L Manzi Jr., MD, INC

  • Ophthalmology Physician
  • Fountain Valley, CA
National Provider Identifier
1376592188
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G27003 Issued in CA
Practice address
18426 Brookhurst St
Suite # 103
Fountain Valley, CA 92708-6776
Phone
(714) 546-2020
Fax
(714) 436-2929
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G27003 CA Primary

Addresses

Primary practice location

18426 Brookhurst St
Suite # 103
Fountain Valley, CA 92708-6776

Mailing address

18426 Brookhurst St
Suite 103
Fountain Valley, CA 92708-6776
Phone (714) 546-2020

Other identifiers 1

IdentifierTypeStateIssuer
00G270030MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G27003CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Baran Jr MD Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1376592188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18426 BROOKHURST ST",
            "address_2": "SUITE 103",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086776",
            "telephone_number": "714-546-2020",
            "fax_number": "714-436-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18426 BROOKHURST ST",
            "address_2": "SUITE # 103",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086776",
            "telephone_number": "714-546-2020",
            "fax_number": "714-436-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZI",
        "first_name": "LINCOLN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD, INC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G27003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G270030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.