Myers Manga, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA062040 Issued in PA

Practice address

1100 W Town and Country Rd Ste 1600
Orange, CA 92868-4698

Phone

(657) 623-8545

NPI assigned

Dec 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1760078729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1600",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684698",
            "telephone_number": "657-623-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1600",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684698",
            "telephone_number": "657-623-8545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W Lehigh Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191322652",
            "country_code": "US",
            "telephone_number": "267-628-6986 x303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGA",
        "first_name": "MYERS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Itzel Berenice Mancilla-Murillo, LCGC
• Brianna Alexis Mancilla
• Jennifer Wahida Mandhai, FNP
• Emily Mandujano
• Marcus David Manette
• Marielle Ann Mangahas
• Jacquelyn Manguilar
• Michael Maranan Manio
• Christina Megumi Manis
• Chaitra Manjunath, MD

• Physician Assistant in Orange, CA
• Providers in Orange, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.