| Manikanda Raja Md A Professional Medical Corporation | |
|
1701 E Florida Ave Hemet CA 92544-4632 | |
| (951) 658-4486 | |
| (951) 925-1666 |
| Full Name | Manikanda Raja Md A Professional Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 1701 E Florida Ave, Hemet, California |
| Authorized Official Name and Position | Manikanda Raja (PRESIDENT) |
| Authorized Official Contact | 9516584486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manikanda Raja Md A Professional Medical Corporation 1701 E Florida Ave Hemet CA 92544-4632 Ph: (951) 658-4486 | Manikanda Raja Md A Professional Medical Corporation 1701 E Florida Ave Hemet CA 92544-4632 Ph: (951) 658-4486 |
| NPI Number | 1497147847 |
|---|---|
| Provider Enumeration Date | 02/23/2015 |
| Last Update Date | 04/09/2015 |
| Medicare PECOS PAC ID | 6305159591 |
|---|---|
| Medicare Enrollment ID | O20150716002534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497147847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Secondary |
| Provider Name | Manikanda G Raja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730290321 PECOS PAC ID: 2961589254 Enrollment ID: I20080410000731 |
| Provider Name | Christa R Lawhorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083942734 PECOS PAC ID: 8921124827 Enrollment ID: I20151201000791 |
| Provider Name | Yamuna R Kondapally |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104336361 PECOS PAC ID: 7810314739 Enrollment ID: I20200824002140 |
| Provider Name | Tyrelle Kate Elizabeth Hunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558985390 PECOS PAC ID: 2163878646 Enrollment ID: I20231020000436 |
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