NPIMap

Organization Active NPI

Manolito B. Fidel, M.D., Inc

  • Psychiatry Physician
  • Torrance, CA
National Provider Identifier
1679859359
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A81909 Issued in CA
Legal business name
MANOLITO B. FIDEL, M.D., INC
Practice address
23700 Camino del Sol
Torrance, CA 90505-5017
Phone
(310) 530-1151
Fax
(310) 626-9390
NPI assigned
Oct 26, 2011
Last updated
Jan 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Authorized official

Name
Manolito B Fidel, MDNPI 1326098534
Title
Owner/Provider
Phone
(424) 400-7748

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A81909 CA Primary

Addresses

Primary practice location

23700 Camino del Sol
Torrance, CA 90505-5017

Mailing address

28919 Covecrest Dr
Rancho Palos Verdes, CA 90275-4703
Phone (424) 400-7748

Other identifiers 1

IdentifierTypeStateIssuer
00A819090MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120207000138 CA Part B Supplier - Clinic/Group Practice 1052578846 Receives reassigned benefits from 8 practitioners
Practice locations: Cerritos, CA; Torrance, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1679859359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28919 COVECREST DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902754703",
            "telephone_number": "424-400-7748",
            "fax_number": "424-400-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23700 CAMINO DEL SOL",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055017",
            "telephone_number": "310-530-1151",
            "fax_number": "310-626-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOLITO B. FIDEL, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "FIDEL",
        "authorized_official_first_name": "MANOLITO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "424-400-7748",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A81909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A819090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.