Provider Demographics
NPI:1760830459
Name:MANILA ZAMAN MD INC
Entity Type:Organization
Organization Name:MANILA ZAMAN MD INC
Other - Org Name:ADVANCED CARDIOVASCULAR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-838-0746
Mailing Address - Street 1:29995 TECHNOLOGY DR STE 302
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2634
Mailing Address - Country:US
Mailing Address - Phone:951-445-4347
Mailing Address - Fax:951-445-4389
Practice Address - Street 1:29995 TECHNOLOGY DR STE 302
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2634
Practice Address - Country:US
Practice Address - Phone:909-838-0746
Practice Address - Fax:951-445-4389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1205861770Medicare UPIN