Individual
DR. GERARD R MANECKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103
(800) 926-8273
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G85298
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G852980
—
CA
Enumeration date
06/08/2006
Last updated
11/20/2019
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