Provider Demographics
NPI:1205861770
Name:ZAMAN, MANILA (MD)
Entity Type:Individual
Prefix:
First Name:MANILA
Middle Name:
Last Name:ZAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29995 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563
Mailing Address - Country:US
Mailing Address - Phone:951-445-4347
Mailing Address - Fax:951-445-4389
Practice Address - Street 1:29995 TECHNOLOGY DR
Practice Address - Street 2:SUITE 302
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2632
Practice Address - Country:US
Practice Address - Phone:951-445-4347
Practice Address - Fax:951-445-4389
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85574207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A855740Medicaid
CA00A855740Medicaid
CA00A855740Medicaid