Individual
RAMIN MANSHADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2633 PACIFIC AVENUE, STOCKTON, CA 95204
(209) 944-5530
(209) 944-5990
Mailing address
PO BOX 4344, STOCKTON, CA 95204-0344
(209) 942-1005
(209) 942-0455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
00A547390
CA
207RC0000X
Cardiovascular Disease Physician
Primary
00A547390
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A547390
—
CA
01
—
060059808
RAILROAD MEDICARE
CA
Enumeration date
09/07/2006
Last updated
02/20/2013
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