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NPI Code Detail

MEDICARE: JANICE E MANJUCK M.D.

MEDICARE: JANICE E MANJUCK M.D.
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianG72767CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386655389
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE E MANJUCK M.D.
Provider Business Mailing Address
First Line : 3687 MT DIABLO BLVD
Second Line :
City : LAFAYETTE
State : CA
Zip : 94549-3717
Country : US
Telephone Number : 925-962-6602
Fax Number : 925-299-6849
Provider Business Practice Location Address
First Line : 3687 MT DIABLO BLVD
Second Line :
City : LAFAYETTE
State : CA
Zip : 94549-3717
Country : US
Telephone Number : 925-962-6602
Fax Number : 925-299-6849
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 12/02/2011

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Directions to “ JANICE E MANJUCK M.D.” Practice Location

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