Healthcare Provider Details

I. General information

NPI: 1093334385
Provider Name (Legal Business Name): MANLIO SINAI HERNANDEZ-CASTILLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 09/05/2023
Certification Date: 04/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 DOLBEER ST.
EUREKA CA
95501-4738
US

IV. Provider business mailing address

200 W. CENTER STREET PROMENADE SUITE 300
ANAHEIM CA
92805-3960
US

V. Phone/Fax

Practice location:
  • Phone: 707-445-8121
  • Fax:
Mailing address:
  • Phone: 213-712-9725
  • Fax: 714-937-6233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA186577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: