Provider Demographics
NPI:1942412903
Name:MANLIGUIS, MAURY PHILIP (DO, MPH (C))
Entity Type:Individual
Prefix:DR
First Name:MAURY
Middle Name:PHILIP
Last Name:MANLIGUIS
Suffix:
Gender:M
Credentials:DO, MPH (C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 CONESTOGA RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-4718
Mailing Address - Country:US
Mailing Address - Phone:816-506-1718
Mailing Address - Fax:
Practice Address - Street 1:303 E VANDERBILT WAY
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3551
Practice Address - Country:US
Practice Address - Phone:909-890-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A93522083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine