Individual provider Active NPI

Carl Jhon Manalo Manigo

  • Registered Nurse
  • Anaheim, CA
National Provider Identifier
1548069461
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95343588 Issued in CA
Practice address
1818 S State College Blvd Unit 436
Anaheim, CA 92806-8921
Phone
(714) 547-7157
NPI assigned
Mar 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95343588 CA Primary

Addresses

Primary practice location

1818 S State College Blvd Unit 436
Anaheim, CA 92806-8921

Mailing address

1818 S State College Blvd Unit 436
Anaheim, CA 92806-8921

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

State licenses

LicenseStateTypeSpecialty
95343588CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1741737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1548069461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 S STATE COLLEGE BLVD UNIT 436",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928068921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 S STATE COLLEGE BLVD UNIT 436",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928068921",
            "telephone_number": "714-547-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIGO",
        "first_name": "CARL JHON",
        "middle_name": "MANALO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95343588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.