Provider Demographics
NPI:1306285739
Name:JHAVERI, MANAN A (MD)
Entity type:Individual
Prefix:
First Name:MANAN
Middle Name:A
Last Name:JHAVERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3160 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5202
Mailing Address - Country:US
Mailing Address - Phone:859-489-6068
Mailing Address - Fax:859-838-9220
Practice Address - Street 1:4516 JUNEBERRY DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-3900
Practice Address - Country:US
Practice Address - Phone:859-489-7068
Practice Address - Fax:859-838-9220
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA168382207RG0100X
NY297953207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine