Provider Demographics
NPI:1871014605
Name:MANHAS, VISHAL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:VISHAL
Middle Name:
Last Name:MANHAS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 N SCHNOOR ST APT 203
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-4982
Mailing Address - Country:US
Mailing Address - Phone:951-333-4711
Mailing Address - Fax:
Practice Address - Street 1:2210 N SCHNOOR ST APT 203
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-4982
Practice Address - Country:US
Practice Address - Phone:951-333-4711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-01
Last Update Date:2017-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant