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Organization

JERRY MANOUKIAN M.D. A MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JERRY LEE MANOUKIAN M.D. (OWNER)
(650) 940-1006
Entity
Organization

Contact information

Practice address
2500 HOSPITAL DR, SUITE 4, MOUNTAIN VIEW, CA 94040-4106
(650) 940-1006
(650) 940-1008
Mailing address
2500 HOSPITAL DR, SUITE 4, MOUNTAIN VIEW, CA 94040-4106
(650) 940-1006
(650) 940-1008

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
G64508
CA

Other

Enumeration date
03/31/2008
Last updated
07/03/2008
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