MICHAEL ANTHONY MANZANO
NPI 1376117598
Student in an Organized Health Care Education/Training Program in San Diego, CA

Active since May 13, 2021PECOS Enrolled
3665 KEARNY VILLA RD STE 101, SAN DIEGO, CA 92123(949) 874-2757 Get Directions Write a Review

NPPES record last updated: May 13, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Michael Anthony Manzano NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL ANTHONY MANZANO (NPI 1376117598) is an individual student in an organized health care education/training program in San Diego, California and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of University Of California, San Diego School Of Medicine (2024).

NPPES Registry Identity

NPI1376117598
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMICHAEL ANTHONY MANZANO
Location Address3665 KEARNY VILLA RD STE 101San Diego, CA 92123-1954
Mailing Address3754 1st Ave Apt CSan Diego, CA 92103-4089 · (949) 874-2757
Sole ProprietorNo
Medical School CMSUniversity Of California, San Diego School Of MedicineGraduated 2024
Enumeration DateMay 13, 2021
NPPES CertifiedMay 13, 2021
NPI 1376117598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3665 KEARNY VILLA RD STE 101, San Diego, CA 92123

Secondary Practice Location 1

Location 13754 1st Ave Apt CSan Diego, CA 92103-4089 · Phone (949) 874-2757

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Michael Anthony Manzano is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3375027808
PECOS Enrollment IDI20260323001195
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Student in an Organized Health Care Education/Training Program
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
Social Worker
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
Marriage & Family Therapist
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
Social Worker (Clinical)
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
Student in an Organized Health Care Education/Training Program
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
Student in an Organized Health Care Education/Training Program
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
Social Worker
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
Student in an Organized Health Care Education/Training Program
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Manzano's NPI number?

The NPI number for Michael Manzano is 1376117598. It was assigned to this individual provider in the NPPES registry on May 13, 2021.

Where is Michael Manzano located?

Michael Manzano practices at 3665 Kearny Villa Rd Ste 101, San Diego, CA 92123. The listed phone number is (949) 874-2757.

What is Michael Manzano's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Michael Manzano enrolled in Medicare?

Yes. Michael Manzano is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Michael Manzano was last updated on May 13, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.