MEDICARE: MARTHA CHUNG-SANG MAN 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	207R00000X	Internal Medicine Physician	A82063	CA
2	207RH0000X	Hematology (Internal Medicine) Physician	A82063	CA
3	207RH0003X	Hematology & Oncology Physician	A82063	CA
4	207RX0202X	Medical Oncology Physician	A82063	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518976042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA CHUNG-SANG MAN MD

Provider Business Mailing Address
First Line	:	2589 SAMARITAN DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4102
Country	:	US
Telephone Number	:	408-426-4900
Fax Number	:	669-233-2482

Provider Business Practice Location Address
First Line	:	2589 SAMARITAN DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4102
Country	:	US
Telephone Number	:	408-426-4900
Fax Number	:	669-233-2482

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	04/12/2024

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