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NPI Code Detail

MEDICARE: DR. VERONICA MANWAI NG M.D.

MEDICARE: DR. VERONICA MANWAI NG 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
1174400000XSpecialistG72891CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2ZZZ23128ZOTHERCAMEDICARE GROUP ID NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G72891OTHERCACA STATE LICENSE NUMBER

General Provider Information

NPI Number : 1871532655
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VERONICA MANWAI NG M.D.
Provider Business Mailing Address
First Line : 1200 SONOMA AVE
Second Line : STE. 1
City : SANTA ROSA
State : CA
Zip : 95405-6664
Country : US
Telephone Number : 707-575-8570
Fax Number : 707-575-5014
Provider Business Practice Location Address
First Line : 1200 SONOMA AVE
Second Line : STE. 1
City : SANTA ROSA
State : CA
Zip : 95405-6664
Country : US
Telephone Number : 707-575-8570
Fax Number : 707-575-5014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 07/08/2007

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