Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PREMALATA MANICKAM, M.D.

Active Sole Proprietor

Pediatrics · FONTANA, CA

Registration Details

NPI Number: 1154353654
Provider Type: Individual
Gender: Female
NPI Issued: Jul 7, 2006 (19.791159393718 yrs)
Last Updated: Oct 13, 2021
License: C52156 (CA)
Sole Proprietor: Yes

Practice Information

Address: 9985 SIERRA AVE

KAISER PERMANENTE, MOB 2B

FONTANA, CA, 923356720
Browse CA providers · Browse ZIP 92335
Phone: 9094275993
Fax: 9094274287
Primary Specialty: Pediatrics
208000000X

Other Pediatrics Providers in FONTANA, CA

Name	Credential	NPI
DR. RICHARD C CHANG	M.D.	1831195882
EVANGELINE AUSTRIA GIMBEL	MD	1164493888
DR. NAMITA P. MOHIDEEN	M.D.	1871543850
DR. LETICIA M. CADIZ	M.D.	1295781946
VIRNA CORAZON PAJE	MD	1679518203
DR. ALBERT F. DINICOLA	M.D.	1801829528

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.