Edgar Ivan Manzano, is a
Psychologist - Addiction (substance Use Disorder) based in San Rafael, California. Edgar Ivan Manzano is licensed to practice in * (Not Available) (license number ) and his current practice location is
1601 2nd St, San Rafael, California. He can be reached at his office (for appointments etc.) via phone at
(415) 456-6655.
NPI number for Edgar Ivan Manzano is 1730952573 and his current mailing address is 1601 2nd St, San Rafael, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1730952573.
Healthcare Provider's Profile
| Full Name | Edgar Ivan Manzano |
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| Gender | Male |
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| Speciality | Psychologist - Addiction (substance Use Disorder) |
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| Location | 1601 2nd St, San Rafael, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1730952573
- Provider Enumeration Date: 11/02/2023
- Last Update Date: 11/06/2023
Medical Identifiers
Medical identifiers for Edgar Ivan Manzano such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730952573 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Edgar Ivan Manzano is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Edgar Ivan Manzano,
1601 2nd St,
San Rafael, CA 94901-2712
Ph: (415) 456-6655 | Edgar Ivan Manzano,
1601 2nd St,
San Rafael, CA 94901-2712
Ph: (415) 456-6655 |
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