Provider Demographics
NPI:1114197712
Name:MANUJ NANGIA, MD, INC
Entity Type:Organization
Organization Name:MANUJ NANGIA, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUJ
Authorized Official - Middle Name:
Authorized Official - Last Name:NANGIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-218-2094
Mailing Address - Street 1:2516 SAMARITAN DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4108
Mailing Address - Country:US
Mailing Address - Phone:650-218-2094
Mailing Address - Fax:650-475-8434
Practice Address - Street 1:2516 SAMARITAN DR
Practice Address - Street 2:SUITE G
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4108
Practice Address - Country:US
Practice Address - Phone:650-218-2094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA917112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty