MEDICARE: DR. EVELYN MANALILI MUSNI M.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	207UN0901X	Nuclear Cardiology Physician	A82026	CA
2	207UN0902X	Nuclear Imaging & Therapy Physician	A82026	CA

General Provider Information

NPI Number	:	1699751222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVELYN MANALILI MUSNI M.D.

Provider Business Mailing Address
First Line	:	2 JIB CT
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-1208
Country	:	US
Telephone Number	:	925-691-9718
Fax Number	:	925-691-9718

Provider Business Practice Location Address
First Line	:	1860 MOWRY AVE STE 200
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1730
Country	:	US
Telephone Number	:	510-790-2202
Fax Number	:	510-790-2806

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	05/26/2016

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