MEDICARE: REYOLITO MANIWANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility		CA

General Provider Information

NPI Number	:	1386516714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REYOLITO MANIWANG

Provider Business Mailing Address
First Line	:	15002 FLATBUSH AVE
Second Line	:
City	:	NORWALK
State	:	CA
Zip	:	90650-5320
Country	:	US
Telephone Number	:	714-317-4740
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 WHITE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-1322
Country	:	US
Telephone Number	:	714-317-4740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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Directions to “ REYOLITO MANIWANG ” Practice Location

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