Mancino, Robert J

Mancino, Robert J is an sole proprietor health care provider with primary practice located at 14810 Cresta Ave , Clearlake CA 95422-8188. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Radiography, which is considered as his primary health care specialty. Mancino, Robert J can be contacted via phone (707) 994-4965.

Contact Information

Primary practice address
14810 Cresta Ave Clearlake CA 95422-8188
Phone: (707) 994-4965
Fax: (707) 994-4965
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Radiography 2471C3402X RHT19556 California

Profile Details

NPI number 1124110762
LBN Legal business name Mancino, Robert J
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 29th, 2006
Last updated Dec 13th, 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 1124110762 NPPES
California Other XR000131F MEDI-CAL

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