Individual provider Active NPI

Carlos Jordan-Manzano, M.D.

  • Psychiatry Physician
  • Torrance, CA
National Provider Identifier
1922203157
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A106140 Issued in CA
Practice address
23700 Camino del Sol
Torrance, CA 90505
Phone
(310) 530-1151
Fax
(310) 626-9390
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A106140 CA
Psychiatry Physician 2084P0800X A106140 CA Primary

Addresses

Primary practice location

23700 Camino del Sol
Torrance, CA 90505

Mailing address

PO Box 4570
Palos Verdes Peninsula, CA 90274-9607
Phone (424) 400-7748

Other practice location 1

1000 W Carson St.
D 5.5
Torrance, CA 90509
Phone (310) 222-1605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131112001980 CA Practitioner - Psychiatry 3870729254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

921 E Compton Blvd
Compton, CA 90221-3303
Phone (424) 444-5877

921 E Compton Blvd 1St FL
Compton MHS
Compton, CA 90221-3303
Phone (310) 668-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A106140CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 23, 2013 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 23, 2013 Accepting new patients

Locations

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

921 E Compton Blvd
Fl 1
Compton, CA 90221
Phone (310) 668-6800

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

1000 W Carson St
#55
Torrance, CA 90502
Phone (310) 222-1605

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1922203157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4570",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902749607",
            "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": "90505",
            "telephone_number": "310-530-1151",
            "fax_number": "310-626-9390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St.",
            "address_2": "D 5.5",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "90509",
            "country_code": "US",
            "telephone_number": "310-222-1605",
            "fax_number": "310-328-7217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN-MANZANO",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A106140",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A106140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.