Individual
RABIA MANZOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17051 SIERRA LAKES PKWY, STE 101, FONTANA, CA 92336-1274
(909) 428-2040
(909) 428-2191
Mailing address
17051 SIERRA LAKES PKWY, STE 101, FONTANA, CA 92336-1274
(909) 428-2040
(909) 428-2191
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
01059273A
IN
2080A0000X
Pediatric Adolescent Medicine Physician
036121105
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200479440
—
IN
01
—
553180
MEDICARE GROUP NUMBER
IL
Enumeration date
12/12/2006
Last updated
12/06/2021
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