Manifest Health & Wellness Acupuncture, Inc.

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

MANIFEST HEALTH & WELLNESS ACUPUNCTURE, INC.

Practice address

4501 Mission Bay Dr Ste 2D
San Diego, CA 92109-4925

Phone

(858) 333-7907

NPI assigned

Nov 30, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Kolin Durrant, DACM, L.AC.NPI 1891453593

Title

Ceo

Phone

(858) 333-7907

Specialties & licenses 1

Addresses

Other names 1

• Manifest Health & Wellness Doing business as

Practitioners 1

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

• Kolin Durrant, DACM, L.AC.

  • Acupuncturist
  • San Diego, CA
  • NPI 1891453593
  NPD Authorized official

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1902564628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 GOLDEN GATE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161138",
            "telephone_number": "619-550-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 MISSION BAY DR STE 2D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094925",
            "telephone_number": "858-333-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIFEST HEALTH & WELLNESS ACUPUNCTURE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "DURRANT",
        "authorized_official_first_name": "KOLIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-333-7907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DACM, L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manifest Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard G. Mangusan, PHARMACY TECHNICIAN
• Ian Tran Manh
• Lynn P. Manheim, P.N.P.
• Parvin Pam Mani, M.D.
• Gladys Torres Maniego
• Maxim Raymundo Maningas, ACSW
• Noelynn Manio
• Hilary Manion, MA
• Nathan James Maniquis
• Laura Manjarrez, NHE

• Acupuncturist in San Diego, CA
• Providers in San Diego, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.