Individual
DR. MATTHEW SHAHRAM MANIGHALAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10050 N WOLFE RD, CUPERTINO, CA 95014-2519
(408) 236-6160
Mailing address
10050 N WOLFE RD, CUPERTINO, CA 95014-2519
(714) 726-6266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2018011141
MO
261QX0100X
Occupational Medicine Clinic/Center
Primary
A192257
CA
390200000X
Student in an Organized Health Care Education/Training Program
2018011141
TX
Other
Enumeration date
07/16/2018
Last updated
02/02/2024
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