De La Cruz, Manuel R

De La Cruz, Manuel R is an individual health care provider with primary practice located at 518 W Eaton Ave , Tracy CA 95376-3422. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. De La Cruz, Manuel R can be contacted via phone (209) 833-2228.

Contact Information

Primary practice address
518 W Eaton Ave Tracy CA 95376-3422
Phone: (209) 833-2228
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A50064 California

Profile Details

NPI number 1164522546
LBN Legal business name De La Cruz, Manuel R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1164522546 NPPES
California Other ZZZ01387Z BLUE SHIELD GROUP ID #

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