| Manzanita Medical Clinic | |
|
5810 Jameson Ct Ste 1 Carmichael CA 95608 | |
| (916) 979-0621 | |
| (916) 979-1110 |
| Full Name | Manzanita Medical Clinic |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5810 Jameson Ct, Carmichael, California |
| Authorized Official Name and Position | Larisa Kravchuk (MANAGER) |
| Authorized Official Contact | 9169790621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manzanita Medical Clinic 5810 Jameson Ct Carmichael CA 95608-0881 Ph: (916) 979-0621 | Manzanita Medical Clinic 5810 Jameson Ct Ste 1 Carmichael CA 95608 Ph: (916) 979-0621 |
| NPI Number | 1700977188 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 04/30/2020 |
| Medicare PECOS PAC ID | 6507765971 |
|---|---|
| Medicare Enrollment ID | O20040218000540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700977188 | NPI | - | NPPES |
| GR0080910 | Medicaid | CA |
| Provider Name | Vladimir Rafanov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477537413 PECOS PAC ID: 5698722957 Enrollment ID: I20050407001222 |
| Provider Name | Arnold Greenberg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780616177 PECOS PAC ID: 4284529231 Enrollment ID: I20071208000082 |
| Provider Name | Pavel Polskiy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386735777 PECOS PAC ID: 8820135288 Enrollment ID: I20091017000049 |
| Provider Name | Anna Roysman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063503464 PECOS PAC ID: 9537336649 Enrollment ID: I20120112000512 |
| Provider Name | Spencer Silverbach |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245287846 PECOS PAC ID: 1951215680 Enrollment ID: I20130603000103 |
| Provider Name | Vanessa June R Pontillas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740631753 PECOS PAC ID: 1456649052 Enrollment ID: I20161014000797 |
| Provider Name | Harmandeep S Dhaliwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023538105 PECOS PAC ID: 8123457637 Enrollment ID: I20200404000427 |
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