Healthcare Provider Details

I. General information

NPI: 1174635098
Provider Name (Legal Business Name): MANISH SOMANI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8929 PANAMA RD STE.B
LAMONT CA
93241-1740
US

IV. Provider business mailing address

8929 PANAMA RD STE.B
LAMONT CA
93241-1740
US

V. Phone/Fax

Practice location:
  • Phone: 661-845-3551
  • Fax: 661-845-8450
Mailing address:
  • Phone: 661-845-3551
  • Fax: 661-845-8450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY44332
License Number StateCA

VIII. Authorized Official

Name: MANISH K SOMANI
Title or Position: CEO
Credential:
Phone: 661-845-3551