Provider Demographics
NPI:1497018584
Name:TOVAR, MANUEL (PA)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:TOVAR
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:81709 DR CARREON BLVD STE D2
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5578
Mailing Address - Country:US
Mailing Address - Phone:760-625-0545
Mailing Address - Fax:760-625-0546
Practice Address - Street 1:82013 DOCTOR CARREON BLVD
Practice Address - Street 2:SUITE M
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-4832
Practice Address - Country:US
Practice Address - Phone:760-342-4242
Practice Address - Fax:760-342-4233
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2022-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA22256363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant