Healthcare Provider Details

I. General information

NPI: 1851315980
Provider Name (Legal Business Name): MANUEL RAMON SACAPANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21530 PIONEER BLVD
HAWAIIAN GARDENS CA
90716-2608
US

IV. Provider business mailing address

12376 PRIMROSE AVE
WHITTIER CA
90602-1094
US

V. Phone/Fax

Practice location:
  • Phone: 714-522-2001
  • Fax: 714-522-7503
Mailing address:
  • Phone: 818-450-4649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA77588
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: