MEDICARE: DR. LUCIO MANLIO NOBILE MD

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	207R00000X	Internal Medicine Physician	A81546	CA
2	207RX0202X	Medical Oncology Physician	A81546	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A81546	OTHER	CA	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	10965331	OTHER		CAQH NUMBER
4	20487	OTHER	NV	NEVADA MED LICENSE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396828588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCIO MANLIO NOBILE MD

Provider Business Mailing Address
First Line	:	6121 N THESTA ST STE 204
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5294
Country	:	US
Telephone Number	:	559-650-4831
Fax Number	:	559-650-4790

Provider Business Practice Location Address
First Line	:	7300 N FRESNO -PALM 3
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-9372
Country	:	US
Telephone Number	:	559-448-5524
Fax Number	:

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	02/25/2025

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