| Carlos Jordan Manzano Md Inc | |
|
23700 Camino Del Sol Torrance CA 90505-5017 | |
| (310) 530-1151 | |
| (310) 626-9390 |
| Full Name | Carlos Jordan Manzano Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 23700 Camino Del Sol, Torrance, California |
| Authorized Official Name and Position | Carlos Jordan-manzano (OWNER) |
| Authorized Official Contact | 4244007748 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlos Jordan Manzano Md Inc Po Box 4570 Palos Verdes Peninsula CA 90274-9607 Ph: (424) 400-7748 | Carlos Jordan Manzano Md Inc 23700 Camino Del Sol Torrance CA 90505-5017 Ph: (310) 530-1151 |
| NPI Number | 1629556501 |
|---|---|
| Provider Enumeration Date | 08/01/2018 |
| Last Update Date | 08/01/2018 |
| Medicare PECOS PAC ID | 9739426966 |
|---|---|
| Medicare Enrollment ID | O20190126000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629556501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A106140 (California) | Primary |
| Provider Name | Carlos Jordan-manzano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922203157 PECOS PAC ID: 3870729254 Enrollment ID: I20131112001980 |
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