Healthcare Provider Details

I. General information

NPI: 1508860412
Provider Name (Legal Business Name): MANUEL ARROYO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date: 03/21/2006
Reactivation Date: 03/29/2006

III. Provider practice location address

43839 15TH ST W
LANCASTER CA
93534-4756
US

IV. Provider business mailing address

43839 15TH ST WEST
LANCASTER CA
93534-4756
US

V. Phone/Fax

Practice location:
  • Phone: 661-945-5984
  • Fax: 661-951-3192
Mailing address:
  • Phone: 661-951-3009
  • Fax: 661-951-3192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG48417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: