Provider Demographics
NPI:1235531492
Name:MANZO, URIEL (MD)
Entity Type:Individual
Prefix:
First Name:URIEL
Middle Name:
Last Name:MANZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5523 COBURN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-5688
Mailing Address - Country:US
Mailing Address - Phone:650-704-5841
Mailing Address - Fax:
Practice Address - Street 1:5523 COBURN RIDGE CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-5688
Practice Address - Country:US
Practice Address - Phone:650-704-5841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91027207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine