Individual
MANISH CHAMPANERIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12395 EL CAMINO REAL STE 112, SAN DIEGO, CA 92130
(858) 554-9930
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 554-9930
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
A105454
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD60337579
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437356375
—
WA
Enumeration date
07/02/2007
Last updated
12/27/2018
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