Organization
EAST LOS ANGELES CARDIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAINIER A MANZANILLA M.D. (OWNER/PRESIDENT)
(323) 441-1122
Entity
Organization
Contact information
Practice address
1701 E CESAR E CHAVEZ AVE, SUITE 125, LOS ANGELES, CA 90033-2464
(323) 441-1122
(323) 441-1172
Mailing address
1701 E CESAR E CHAVEZ AVE, SUITE 125, LOS ANGELES, CA 90033-2464
(323) 441-1122
(323) 441-1172
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0086490
—
CA
Enumeration date
11/03/2006
Last updated
03/01/2013
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