Organization
MARI CARLO MANZANA, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARI CARLO MANZANA MD (CEO)
(661) 714-1560
Entity
Organization
Contact information
Practice address
2410 COMMERCE TRL, IMPERIAL, CA 92251-4003
(661) 714-1560
Mailing address
PO BOX 66, IMPERIAL, CA 92251-0066
(760) 332-8688
(847) 221-6838
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
09/05/2020
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