Provider Demographics
NPI:1598804817
Name:MANOLAKAS, ROBERT GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGE
Last Name:MANOLAKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:24411 HEALTH CENTER DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3651
Mailing Address - Country:US
Mailing Address - Phone:949-716-8752
Mailing Address - Fax:949-770-0869
Practice Address - Street 1:24411 HEALTH CENTER DR
Practice Address - Street 2:SUITE 320
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3651
Practice Address - Country:US
Practice Address - Phone:949-716-8752
Practice Address - Fax:949-770-0869
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG050721208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation