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General NPI Number Information
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NPI Number | 1912352774
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Entity Type | Organization
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Legal Business Name | GAYTRI MANEK MD INC
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Dates
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Enumeration Date | 04/29/2016
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 11180 WARNER AVE STE 271
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7501
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Country | US
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Telephone | 714-435-0150
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Fax | 714-436-0126
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Provider Business Mailing Address
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Address Line | 11180 WARNER AVE STE 271
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7501
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Country | US
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Telephone | 714-435-0150
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Fax | 714-436-0126
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Authorized Official
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Title or Position | OWNER
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Name | GAYTRI MANEK
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Credential | MD
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Telephone | 714-435-0150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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