Provider Demographics
NPI:1487834792
Name:GIGENA, MANUEL (MD)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:GIGENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 N MAPLE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-8010
Mailing Address - Country:US
Mailing Address - Phone:559-325-7855
Mailing Address - Fax:559-325-7866
Practice Address - Street 1:7015 N MAPLE AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-8010
Practice Address - Country:US
Practice Address - Phone:559-325-7855
Practice Address - Fax:559-325-7866
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1235452086S0122X
ORMD27893208600000X
ORMD1810332086S0122X
CAC1998212086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery