Healthcare Provider Details

I. General information

NPI: 1477481570
Provider Name (Legal Business Name): PRECISION METABOLIX A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 CAMINO DE LOS MARES STE 302
SAN CLEMENTE CA
92673-2836
US

IV. Provider business mailing address

675 CAMINO DE LOS MARES STE 302
SAN CLEMENTE CA
92673-2836
US

V. Phone/Fax

Practice location:
  • Phone: 949-259-2790
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HEYDI KATERINA MANRIQUE-APARICIO
Title or Position: OWNER
Credential:
Phone: 760-994-3114