Individual
LACEY MANZANARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 W 6TH ST STE 101, CORONA, CA 92882-3349
(951) 737-0910
Mailing address
PO BOX 5089, NORCO, CA 92860-8003
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/27/2021
Last updated
07/15/2023
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