Individual
ELIJAH MANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1360 S ANAHEIM BLVD, ANAHEIM, CA 92805-6205
(714) 225-0169
Mailing address
1360 S ANAHEIM BLVD, ANAHEIM, CA 92805-6258
(949) 610-2845
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
CA
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
08/02/2018
Last updated
03/17/2026
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