Provider Demographics
NPI:1457580417
Name:MANO, QUINTINO
Entity Type:Individual
Prefix:
First Name:QUINTINO
Middle Name:
Last Name:MANO
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 1:3425 LEBON DR
Mailing Address - Street 2:731
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5240
Mailing Address - Country:US
Mailing Address - Phone:619-497-6600
Mailing Address - Fax:
Practice Address - Street 1:3425 LEBON DR
Practice Address - Street 2:731
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5240
Practice Address - Country:US
Practice Address - Phone:619-497-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program