Provider Demographics
NPI:1134681943
Name:MANN, MANJINDER SINGH
Entity type:Individual
Prefix:
First Name:MANJINDER
Middle Name:SINGH
Last Name:MANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7609 WILBUR WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-4927
Mailing Address - Country:US
Mailing Address - Phone:916-296-6698
Mailing Address - Fax:916-563-8955
Practice Address - Street 1:7609 WILBUR WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-4927
Practice Address - Country:US
Practice Address - Phone:916-296-6698
Practice Address - Fax:916-563-8955
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2548318172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver