| Doctor Name: | PREMALATA MANICKAM |
| NPI Number: | 1154353654 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | C52156 |
| Business Practice Address: | 9985 Sierra Ave Kaiser Permanente, Mob 2b Fontana, CA - 923356720 |
| Business Phone Number: | 9094275993 |
| Business Fax Number: | 9094274287 |
| Mailing Address: | 9985 Sierra Ave, Kaiser Permanente ,pediatric Clinic Mob 2b FONTANA |
| State: | CA |
| Postal Code: | 923356720 |
| Phone Number: | 9094275993 |
| Fax Number: | 9094274287 |
| NPI Enumeration Date: | 07/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208000000X |
| License Number: | C52156 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |