Enn Mannard, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C036326 Issued in CA

Practice address

1989 Vicente Dr
San Luis Obispo, CA 93405-6863

Phone

(805) 781-4179

Fax

(805) 781-1265

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Rose Drago Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1568523819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 FLORA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016004",
            "telephone_number": "805-544-2951",
            "fax_number": "805-781-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 VICENTE DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056863",
            "telephone_number": "805-781-4179",
            "fax_number": "805-781-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNARD",
        "first_name": "ENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C036326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "DRAGO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michael J Malotte
• Jeremiah Malzhan
• Zachariah Malzhan, C.P.,C.O.A.
• Nancy Mancha-Whitcomb, LMFT
• Lauryn Alexis Mankarios
• Catherine Manning
• Chris W Manning III, DDS
• Shawnya Marie Manning, LPT
• Divya Manohara
• Disbel Rebeca Mansilla, D.D.S.

• Psychiatry Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.