Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Patrick Manning

Individual provider Family Nurse Practitioner · NPI 1417439647

Mark Patrick Manning is a Nurse Practitioner in San Diego, California. Qualified in 2018, 8 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

5252 Balboa Ave Ste 803
San Diego, CA 92117-6920
Phone: (619) 289-9416
Fax: (619) 204-6087
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95009680 (CA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 95009680 (CA)

Record details

NPI number1417439647
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 4, 2018
Last updated in NPPESJanuary 5, 2026
Certification dateJanuary 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in San Diego