Provider Demographics
NPI:1437283405
Name:NANGIA, MANUJ KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:MANUJ
Middle Name:KUMAR
Last Name:NANGIA
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 1:825 POLLARD RD STE 108
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1435
Mailing Address - Country:US
Mailing Address - Phone:408-357-0105
Mailing Address - Fax:408-357-0105
Practice Address - Street 1:825 POLLARD RD STE 108
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1435
Practice Address - Country:US
Practice Address - Phone:408-357-0105
Practice Address - Fax:408-357-0105
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA917112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A917110Medicaid
CAI70765Medicare UPIN
CA00A917110Medicaid