MEDICARE: JEFFREY MCMANUS 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	174400000X	Specialist	G056160	CA

General Provider Information

NPI Number	:	1871781658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY MCMANUS MD

Provider Business Mailing Address
First Line	:	1320 MARICOPA HWY STE E
Second Line	:
City	:	OJAI
State	:	CA
Zip	:	93023-3154
Country	:	US
Telephone Number	:	805-646-0151
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 MARICOPA HWY STE E
Second Line	:
City	:	OJAI
State	:	CA
Zip	:	93023-3154
Country	:	US
Telephone Number	:	805-646-0151
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY C MCMANUS
Credential	:	MD
Telephone Number	:	805-646-0151

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	02/06/2012

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