Basic Information
| Provider Information | |||||||||
| NPI: | 1275855488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAGYMANYOKI | ||||||||
| FirstName: | ZOLTAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 22405 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631260405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888438475 | ||||||||
| FaxNumber: | 8444103800 | ||||||||
| Practice Location | |||||||||
| Address1: | 3701 S HIGUERA ST | ||||||||
| Address2: | |||||||||
| City: | SAN LUIS OBISPO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934017462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055460907 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2010 | ||||||||
| LastUpdateDate: | 10/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZC0500X | A129351 | CA | N | Allopathic & Osteopathic Physicians | Pathology | Cytopathology | 207ZP0007X | A129351 | CA | N | Allopathic & Osteopathic Physicians | Pathology | Molecular Genetic Pathology | 207ZP0101X | A129351 | CA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology |
No ID Information.