person
Robert J Mancino
Radiography Radiologic Technologist in Clearlake, California
NPI 1124110762

Robert J Mancino is a Radiography Radiologic Technologist based in Clearlake, CA and is specialized in Radiography. Robert J Mancino practices in Clearlake, CA. The NPI Number for Robert J Mancino is 1124110762 and holds a License No. RHT19556 (California).

The current practice location address for Robert J Mancino is 14810 Cresta Ave, Clearlake, CA and can be reached out via phone at 707-994-4965 and via fax at 707-994-4965.

Location: 14810 Cresta Ave, Clearlake, CA, 95422-0236
person
Provider Profile Details
NPI Number
1124110762
Provider Name
Robert J Mancino
Credential
Provider Entity Type
Individual
Gender
Male
Address
14810 Cresta Ave, Clearlake, CA, 95422-0236
Phone Number
707-994-4965
Fax Number
707-994-4965
Provider Enumeration Date
09/29/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
XR000131F 01 CA MEDI-CAL
institution
Provider Business Practice Location Address Details
Address
14810 Cresta Ave
City
State
Zip
95422-8188
Phone Number
707-994-4965
Fax Number
707-994-4965
person
Provider Business Mailing Address Details
Address
14810 Cresta Ave
City
State
Zip
95422-8188
Phone Number
707-994-4965
Fax Number
707-994-4965
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
Radiography
Taxonomy
License No.
RHT19556 (California)
Definition
Definition to come...
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