MEDICARE: DR. DANIEL V. MANZANARES MD

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	207Q00000X	Family Medicine Physician	24243	AZ

General Provider Information

NPI Number	:	1285799197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL V. MANZANARES MD

Provider Business Mailing Address
First Line	:	1343 N ALMA SCHOOL RD
Second Line	:	STE 160
City	:	CHANDLER
State	:	AZ
Zip	:	85224-5901
Country	:	US
Telephone Number	:	602-866-5070
Fax Number	:	602-866-5093

Provider Business Practice Location Address
First Line	:	5422 W THUNDERBIRD RD
Second Line	:	SUITE 2
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4700
Country	:	US
Telephone Number	:	602-866-5070
Fax Number	:	602-866-5093

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

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	03/08/2017

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