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Organization
KATHERINE MANASSON M.D., INC.
Active
Organization
KATHERINE MANASSON M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE MANASSON M.D. (PRESIDENT)
(949) 751-7604
Entity
Organization
Contact information
Practice address
26732 CROWN VALLEY PKWY, SUITE 507, MISSION VIEJO, CA 92691-6306
(949) 348-1086
(949) 348-1087
Mailing address
54 CORAL LK, IRVINE, CA 92614-5443
(949) 751-7604
(949) 348-1087
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A61594
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A615940
—
CA
01
—
W19900
MEDICARE PTAN
CA
Enumeration date
05/12/2006
Last updated
03/20/2008
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