Individual
CAROL MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3320 N LOS COYOTES DIAGONAL, SUITE 120, 112 & 260, LONG BEACH, CA 90808-3918
(562) 627-0903
(562) 627-0923
Mailing address
1160 PITTSFORD VICTOR RD, D-2, PITTSFORD, NY 14534-3825
(585) 218-8007
(585) 218-8099
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G40306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G403060
BLUE SHIELD
CA
05
—
00G403060
—
CA
Enumeration date
07/12/2006
Last updated
02/11/2015
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