Individual
LUKE ALEX PACQUING MANALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95160452
CA
367500000X
Certified Registered Nurse Anesthetist
2001843
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001660
CA
Other
Enumeration date
08/25/2019
Last updated
07/07/2025
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