Provider Demographics
NPI:1699137661
Name:ABDELMEGEED, MANAR AHMED (MD)
Entity type:Individual
Prefix:
First Name:MANAR
Middle Name:AHMED
Last Name:ABDELMEGEED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 TWINLAKE DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94089-2045
Mailing Address - Country:US
Mailing Address - Phone:612-636-2055
Mailing Address - Fax:
Practice Address - Street 1:1101 S WINCHESTER BLVD STE J205
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3918
Practice Address - Country:US
Practice Address - Phone:612-636-2055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1582042084P0804X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry