Cyrus R. Mancherje, M.D., Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

A41743 Issued in CA

Legal business name

CYRUS R. MANCHERJE, M.D., INC.

Practice address

1860 Pennsylvania Ave Ste 120
Fairfield, CA 94533-3550

Phone

(707) 646-4400

Fax

(707) 646-4401

NPI assigned

Feb 24, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Marion Cooper

Title

Billing Account Manager

Phone

(415) 609-8513

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1447642723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 BUSINESS CENTER DR STE 185",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341643",
            "telephone_number": "415-609-8513",
            "fax_number": "707-689-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE STE 120",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333550",
            "telephone_number": "707-646-4400",
            "fax_number": "707-646-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYRUS R. MANCHERJE, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "MARION",
        "authorized_official_title_or_position": "BILLING ACCOUNT MANAGER",
        "authorized_official_telephone_number": "415-609-8513",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A41743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Lynn Cunningham, MFTI
• Kyle Ryan Cunningham, LVN
• Jerome David Curenton, C.A.S., RASI
• Shannon Curtis
• Alexandra Nicole Cussins
• Michael D'Amico, PHARM.D
• Shawanda Dabbs
• Patrick Mark Mempin Dacullo, RN
• Douglas Granada Dado, DNP
• Marc J Daguio, RAD-T

• Medical Specialty Clinic/Center in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.