Provider Demographics
NPI:1063942993
Name:MANIX MEDICAL INC
Entity type:Organization
Organization Name:MANIX MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:MANIX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-693-2600
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92244-0550
Mailing Address - Country:US
Mailing Address - Phone:760-693-2600
Mailing Address - Fax:844-965-9813
Practice Address - Street 1:1500 S IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4241
Practice Address - Country:US
Practice Address - Phone:760-693-2600
Practice Address - Fax:844-965-9813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty