MEDICARE: DR. THOMAS C MANHEIM PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC38369	CA

General Provider Information

NPI Number	:	1164600631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS C MANHEIM PH.D.

Provider Business Mailing Address
First Line	:	990 HIGHLAND DR
Second Line	:	212-C
City	:	SOLANA BEACH
State	:	CA
Zip	:	92075-2408
Country	:	US
Telephone Number	:	858-729-1133
Fax Number	:

Provider Business Practice Location Address
First Line	:	990 HIGHLAND DR
Second Line	:	212-C
City	:	SOLANA BEACH
State	:	CA
Zip	:	92075-2408
Country	:	US
Telephone Number	:	858-729-1133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	02/06/2008

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