| Manolito B. Fidel, M.d., Inc | |
|
23700 Camino Del Sol Torrance CA 90505-5017 | |
| (310) 530-1151 | |
| (310) 626-9390 |
| Full Name | Manolito B. Fidel, M.d., Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 23700 Camino Del Sol, Torrance, California |
| Authorized Official Name and Position | Manolito B Fidel (OWNER/PROVIDER) |
| Authorized Official Contact | 4244007748 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manolito B. Fidel, M.d., Inc 28919 Covecrest Dr Rancho Palos Verdes CA 90275-4703 Ph: (424) 400-7748 | Manolito B. Fidel, M.d., Inc 23700 Camino Del Sol Torrance CA 90505-5017 Ph: (310) 530-1151 |
| NPI Number | 1679859359 |
|---|---|
| Provider Enumeration Date | 10/26/2011 |
| Last Update Date | 01/10/2024 |
| Certification Date | 01/10/2024 |
| Medicare PECOS PAC ID | 1052578846 |
|---|---|
| Medicare Enrollment ID | O20120207000138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679859359 | NPI | - | NPPES |
| 00A819090 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A81909 (California) | Primary |
| Provider Name | Manolito B Fidel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326098534 PECOS PAC ID: 3072676899 Enrollment ID: I20090106000061 |
| Provider Name | Irine Niuke Achuamang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760999114 PECOS PAC ID: 1759643786 Enrollment ID: I20180402002174 |
| Provider Name | Helen F Ntung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992219661 PECOS PAC ID: 6406181411 Enrollment ID: I20190712002652 |
| Provider Name | John Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821441551 PECOS PAC ID: 5698012615 Enrollment ID: I20210730000461 |
| Provider Name | Esther U Okafor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104073865 PECOS PAC ID: 5991193369 Enrollment ID: I20211104001181 |
| Provider Name | Richard Angelo Monforte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487303475 PECOS PAC ID: 5799154183 Enrollment ID: I20221206003270 |
| Provider Name | Charilyn Bringas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659715266 PECOS PAC ID: 7911181144 Enrollment ID: I20230703002007 |
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