Individual provider Active NPI

Marvin Gil Manalo

  • Family Nurse Practitioner
  • Panorama City, CA
National Provider Identifier
1437971561
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95032534 Issued in CA
Practice address
8215 Van Nuys Blvd Ste 100
Panorama City, CA 91402-4827
Phone
(818) 901-0373
NPI assigned
Oct 29, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95032534 CA Primary

Addresses

Primary practice location

8215 Van Nuys Blvd Ste 100
Panorama City, CA 91402-4827

Mailing address

11856 Balboa Blvd # 470
Granada Hills, CA 91344-2753
Phone (818) 390-0804

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223002969 CA Practitioner - Nurse Practitioner 5799212130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Care Community Health CentersGroup PAC ID 5092218339, 2 clinicians

Practice addresses (Care Compare)

8215 Van Nuys Blvd
Suite 100
Panorama City, CA 91402-4827
Phone (818) 853-8989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mallu Reddy MD Inc Family CurrentSince Oct 20, 2024 Accepting new patients
Mallu Reddy, M.D. Inc. CurrentSince Oct 20, 2024 Accepting new patients

Locations

459 S Azusa Ave
Ste F
Azusa, CA 91702
Phone (626) 969-7538

1196 N Park Ave
Pomona, CA 91768
Phone (909) 623-4050

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1437971561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11856 BALBOA BLVD # 470",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442753",
            "telephone_number": "818-390-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8215 VAN NUYS BLVD STE 100",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024827",
            "telephone_number": "818-901-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALO",
        "first_name": "MARVIN GIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-29",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.