Provider Demographics
NPI:1700838141
Name:MANI, HAMID D (MD)
Entity Type:Individual
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First Name:HAMID
Middle Name:D
Last Name:MANI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:835 THIRD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-1352
Mailing Address - Country:US
Mailing Address - Phone:619-425-7755
Mailing Address - Fax:619-425-9057
Practice Address - Street 1:835 THIRD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1352
Practice Address - Country:US
Practice Address - Phone:619-425-7755
Practice Address - Fax:619-425-9057
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2017-04-05
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Provider Licenses
StateLicense IDTaxonomies
CAA40472207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB64721Medicare UPIN