Provider Demographics
NPI:1922070937
Name:OJHA, MANISHA (MD)
Entity Type:Individual
Prefix:
First Name:MANISHA
Middle Name:
Last Name:OJHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 SAGE DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-5956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MCALLISTER ST
Practice Address - Street 2:STUDENT HEALTH DEPARTMENT, SECOND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4707
Practice Address - Country:US
Practice Address - Phone:415-565-4612
Practice Address - Fax:415-565-4607
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78089208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH56104Medicare UPIN
CAZZZ03062ZMedicare ID - Type Unspecified