Provider Demographics
NPI:1023434016
Name:CADAG, FIDEL MANZANO (NP - C)
Entity type:Individual
Prefix:MR
First Name:FIDEL
Middle Name:MANZANO
Last Name:CADAG
Suffix:
Gender:M
Credentials:NP - C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1850 SULLIVAN AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2221
Mailing Address - Country:US
Mailing Address - Phone:650-755-3939
Mailing Address - Fax:650-755-3883
Practice Address - Street 1:1850 SULLIVAN AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2221
Practice Address - Country:US
Practice Address - Phone:650-755-3939
Practice Address - Fax:650-755-3883
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA23558363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily