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NPI Code Detail

MEDICARE: MRS. ELIZABETH MANUILOVA L.V.N.

MEDICARE: MRS. ELIZABETH MANUILOVA L.V.N.
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
1164X00000XLicensed Vocational NurseVN 192660CA

General Provider Information

NPI Number : 1679646566
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH MANUILOVA L.V.N.
Provider Business Mailing Address
First Line : 8100 OCEANVIEW TER APT 303
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94132-3278
Country : US
Telephone Number : 415-710-0986
Fax Number :
Provider Business Practice Location Address
First Line : 1421 BRODERICK ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-3304
Country : US
Telephone Number : 415-292-1760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 07/08/2007

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