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General NPI Number Information
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NPI Number | 1194915603
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Entity Type | Organization
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Legal Business Name | DANIEL V MANZANARES, MD, PLLC
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 5422 W THUNDERBIRD RD SUITE 2
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City | GLENDALE
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State | AZ
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Zip | 85306-4700
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Country | US
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Telephone | 602-866-5070
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Fax |
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Provider Business Mailing Address
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Address Line | 5422 W THUNDERBIRD RD SUITE 2
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City | GLENDALE
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State | AZ
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Zip | 85306-4700
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Country | US
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Telephone | 602-866-5070
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. DANIEL V MANZANARES
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Credential | M.D.
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Telephone | 602-866-5070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 24243
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License Number State | AZ
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