Manzano, Edgar Ivan

Manzano, Edgar Ivan is an sole proprietor health care provider with primary practice located at 1601 2Nd St , San Rafael CA 94901-2712. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Manzano, Edgar Ivan can be contacted via phone (415) 456-6655.

Contact Information

Primary practice address
1601 2Nd St San Rafael CA 94901-2712
Phone: (415) 456-6655
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X

Profile Details

NPI number 1730952573
LBN Legal business name Manzano, Edgar Ivan
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2023
Last updated Nov 6th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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