Individual
CESAR MAMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
22675 ALESSANDRO BLVD, MORENO VALLEY, CA 92553-8551
(951) 571-2300
(951) 571-2330
Mailing address
1328 S MISSION RD, FALLBROOK, CA 92028-4006
(760) 451-2730
(760) 451-2700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
52428
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC70275G
MEDI-CAL
CO
01
—
HAP70275G
PACT
CA
Enumeration date
02/15/2007
Last updated
01/13/2012
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