Provider Demographics
NPI:1306819271
Name:MANOOGIAN, CARY M (MD)
Entity Type:Individual
Prefix:
First Name:CARY
Middle Name:M
Last Name:MANOOGIAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:145 VISTA AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3607
Mailing Address - Country:US
Mailing Address - Phone:626-397-8335
Mailing Address - Fax:626-397-8350
Practice Address - Street 1:65 N MADISON AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2035
Practice Address - Country:US
Practice Address - Phone:626-792-3141
Practice Address - Fax:626-792-9193
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG50220207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA51610Medicare UPIN