Provider Demographics
NPI:1356670087
Name:MANABAT-HIDALGO, CATHERINE GOZUN (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:GOZUN
Last Name:MANABAT-HIDALGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:GOZUN
Other - Last Name:MANABAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4785 N 1ST ST
Mailing Address - Street 2:DEPT OF DERMATOLOGY
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-0513
Mailing Address - Country:US
Mailing Address - Phone:559-448-4745
Mailing Address - Fax:
Practice Address - Street 1:4785 N 1ST ST
Practice Address - Street 2:DEPT OF DERMATOLOGY
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0513
Practice Address - Country:US
Practice Address - Phone:559-448-4745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130183207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology