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General NPI Number Information
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NPI Number | 1649278599
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Entity Type | Individual
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Provider Name | REX CHANG MANAYAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 3333 CONCOURS STE 100
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City | ONTARIO
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State | CA
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Zip | 91764-4875
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Country | US
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Telephone | 909-481-3242
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Fax | 909-481-3243
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Provider Business Mailing Address
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Address Line | 71780 SAN JACINTO DR BLDG I
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-5516
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Country | US
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Telephone | 760-568-3461
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Fax | 760-423-6273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G86289
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | DR.0059259
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 67209
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 67209
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License Number State | AZ
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