Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | A72413 | CA |
NPI | 1518030352 |
---|---|
Provider Name | Dr. Melanie Manning |
First Address | Palo Alto, CA 94305-5208 |
Second Address | Palo Alto, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A72413 | MEDICAL LICENSE (01) | CA |
BM7084445 | DEA LICENSE (01) | CA |
MD-12560 | MEDICAL LICENSE (01) | HI |