ROBERT J MANCINO NPI 1124110762

NPI Information

NPI: 1124110762
Provider Name: ROBERT J MANCINO
Classification: Radiologic Technologist - 2471C3402X
Entity Type: Individual

Specialization: Radiography

Address:
14810 CRESTA AVE
CLEARLAKE, CA
ZIP 95422
Phone: (707) 994-4965
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Robert J Mancino is a radiography radiologic technologist in Clearlake, CA. Robert J Mancino NPI is 1124110762. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

14810 CRESTA AVE
CLEARLAKE, CA
ZIP 95422-188
Phone: (707) 994-4965
Fax: (707) 994-4965

The enumeration date for this NPI number is 9/29/2006 and was last updated on 12/13/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2471C3402X	Radiologic Technologist	Radiography	RHT19556	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ZZZ00131Z	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	PROVIDER #
2	XR000131F	OTHER	CALIFORNIA	MEDI-CAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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