DR. CORNELIO C. MANZANO JR. (NPI# 1346340494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346340494 |
| Entity Type | Individual |
| Full Name | DR. CORNELIO C. MANZANO JR. |
| Credential | M.D. |
| Practice Address |
6245 De Longpre Ave 206 Hollywood CA 90028-8253 |
| Mailing Address |
3318 Tica Dr Los Angeles CA 90027-1301 |
| Practice Telephone | 3237851223 |
| Mailing Telephone | 3236608951 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-05-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A35893 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A358930 | 05 |
| Street Address |
6245 DE LONGPRE AVE 206 |
| City | HOLLYWOOD |
| State | CA |
| Zip Code | 90028-8253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023010113 | Southern California Healthcare System, Inc | General Acute Care Hospital | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2005-06-02 |
| 1255883005 | Memorial Pathology Medical Group, Inc. | Pathology | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2016-10-27 |
| 1730631730 | Arnel M Joaquin M D Inc | Specialist | 6245 De Longpre Ave, Suite 206, B, Hollywood, CA 90028-8253 | 2016-10-26 |
| 1881898740 | Joel Frederick Fine, Md A Med | Anesthesiology | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2007-06-13 |
| 1265470868 | Ideal Health Care and Medical | Specialist | 6245 De Longpre Ave, 206, Hollywood, CA 90028-8253 | 2006-06-04 |
| 1699713966 | Alexis Nixon | Physician Assistant | 6245 De Longpre Ave, 206, Hollywood, CA 90028-8253 | 2006-06-02 |
| 1730141888 | Patrick L Mullens | Pathology | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2006-04-04 |
| 1144281163 | Kenneth C Nieberg Md Inc | Pathology | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1639715030 | Michelle Jennifer Martinez | Case Manager/Care Coordinator | 6838 Sunset Blvd., Hollywood, CA 90028 | 2019-11-20 |
| 1821562315 | Ronnie Jerome Jackson | Case Manager/Care Coordinator | Bhs Hollywood Recovery Center, 6838 Sunset Blvd, Hollywood, CA 90028 | 2019-01-17 |
| 1669961595 | Danielle Arce | Dietitian, Registered | 6721 De Longpre Ave, Los Angeles, CA 90028 | 2018-05-07 |
| 1982124772 | Yoon Kyung Lee | Pharmacist | 7201 Hollywood Blvd, Los Angeles, CA 90028 | 2017-06-22 |
| 1982133245 | Julia West | Pharmacist | 6201 Hollywood Blvd #126, Los Angeles, CA 90028 | 2017-06-08 |
| 1720527971 | Melissa Susac | Marriage & Family Therapist | 1540 Schrader Blvd, Garden Suite 12, Hollywood, CA 90028 | 2017-02-21 |
| 1023554284 | Arlene Aranda | Social Worker | 1873 Taft Ave, Los Angeles, CA 90028 | 2017-01-12 |
| 1912304775 | Damon Dodge | Marriage & Family Therapist | 7083 Hollywood Blvd, Los Angeles, CA 90028 | 2014-11-21 |
| Find all providers in zip 90028 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1225443559 | Devora Hurwitz | Specialist | 3007 Bogota Ave, Hollywood, FL 33026-4509 | 2014-06-25 |
| 1003159963 | Leaf It Up Medspa,llc | Specialist | 1000 N Broadwalk Ste 1, Hollywood, FL 33019-1221 | 2013-03-29 |
| 1306114285 | Regional Imaging Inc | Specialist | 10786 Charleston Pl, Hollywood, FL 33026-4906 | 2011-12-07 |
| 1720376734 | Early Stages for Early Ages Inc. | Specialist | 203 Sw 85th Terr. Apt. 306, Hollywood, FL 33025 | 2011-07-12 |
| 1184936502 | Adelheid C. Reinoso Md, Pa | Specialist | 3700 Washinton Street, Suite 202, Hollywood, FL 33021-8249 | 2010-07-14 |
| 1922327832 | Andrea Hamilton | Specialist | 7986 Highway 162, Hollywood, SC 29449-5607 | 2010-05-18 |
| 1043538853 | Rosa Guzman | Specialist | 3837 Hollywood Blvd Ste B, Hollywood, FL 33021-1243 | 2010-05-04 |
| 1053577403 | Diane Elizabeth Reynolds | Specialist | 1714 Taft St, Hollywood, FL 33020-2836 | 2008-08-05 |
| 1306019823 | Lorena Lewy-altebaum, Md | Specialist | 3700 Washington St Ste 400, Hollywood, FL 33021-8289 | 2008-04-04 |
| Find all providers in HOLLYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.