Roland J Manurung

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

50608 Issued in CA

Practice address

8465 Chaffee St
Rancho Cucamonga, CA 91730-5009

Phone

(909) 510-0586

NPI assigned

Feb 16, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1760180061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8465 CHAFFEE ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305009",
            "telephone_number": "909-510-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8465 CHAFFEE ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305009",
            "telephone_number": "909-510-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANURUNG",
        "first_name": "ROLAND",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Mann, DPT
• Manor Home Health, Inc.
• Vivian Manriquez Chavez
• Monique Quitoriano Manriquez, LCSW
• Adriana Mansour
• Angelica D Manzo, MA LPCC
• Breanna Manzo
• Tony Mao, RPH
• Jeffrey N Mar, M.D.
• Jasmine Maravilla

• Physical Therapy Assistant in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.