Individual
MARK PATRICK MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5252 BALBOA AVE STE 803, SAN DIEGO, CA 92117-6920
(619) 289-9416
(619) 204-6087
Mailing address
5252 BALBOA AVE STE 803, SAN DIEGO, CA 92117-6920
(619) 289-9416
(619) 204-6087
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95009680
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95009680
CA
Other
Enumeration date
09/04/2018
Last updated
01/05/2026
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