Provider Demographics
NPI:1043768534
Name:MANES, STEVEN (ORTHOPAEDIC TECH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MANES
Suffix:
Gender:M
Credentials:ORTHOPAEDIC TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 RACHELLE WAY
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-1255
Mailing Address - Country:US
Mailing Address - Phone:619-888-4038
Mailing Address - Fax:
Practice Address - Street 1:1027 RACHELLE WAY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:90219
Practice Address - Country:US
Practice Address - Phone:619-888-4038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0938-0931Medicare UPIN