Provider Demographics
NPI:1114614708
Name:DOUROUX, MANUEL LOUIS II
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:LOUIS
Last Name:DOUROUX
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7859 FIRESTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4220
Mailing Address - Country:US
Mailing Address - Phone:562-869-8890
Mailing Address - Fax:562-861-5418
Practice Address - Street 1:7859 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4220
Practice Address - Country:US
Practice Address - Phone:562-869-8890
Practice Address - Fax:562-861-5418
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88302183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician