Mannie Joel MD Inc.

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

A34460 Issued in CA

Legal business name

MANNIE JOEL MD INC.

Practice address

15035 E 14TH St
San Leandro, CA 94578-1901

Phone

(510) 278-0226

Fax

(510) 278-5054

NPI assigned

Apr 9, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Selena M Mainarick

Title

Office Manager

Phone

(510) 278-0226

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Augustine Lague, MPA-C

  • Medical Physician Assistant
  • Redwood City, CA
  • NPI 1295979227
  NPD (past)

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1891938676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15035 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781901",
            "telephone_number": "510-278-0226",
            "fax_number": "510-278-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15035 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781901",
            "telephone_number": "510-278-0226",
            "fax_number": "510-278-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANNIE JOEL MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "MAINARICK",
        "authorized_official_first_name": "SELENA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "510-278-0226",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "CA",
            "license": "A34460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A344600/1720043599",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Manibog, DC
• Rogelia Castro Maniego
• Kiran Kaur Manik-Brittian
• Charlotte Jean Mann, O.T.
• Selena Kaur Mann
• Avon Manning Jr.
• Deserie Manning
• Alithu Andrea Manrique
• Yasin Mansoor, MD
• Sara Mansouri

• Pain Clinic/Center in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Pain Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.