| Doctor Name: | MS. SUSAN T. MANABO |
| NPI Number: | 1063437754 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 285624-11204 |
| Business Practice Address: | 26455 Marsala Way Mission Viejo, CA - 926923264 |
| Business Phone Number: | 9493480476 |
| Business Fax Number: | 2134849939 |
| Mailing Address: | 1800 Wilshire Blvd, LOS ANGELES |
| State: | CA |
| Postal Code: | 900573602 |
| Phone Number: | 9493480476 |
| Fax Number: | 2134849939 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 04/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 285624-11204 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |