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

Shane Manalang, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1558648550

Shane Manalang, PHYSICIANASSISTANT is a Physician Assistant in Lynwood, California. Qualified in 2010, 16 years ago. Practices with Addis Medical Group a Medical Corporation, a 17-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
16
Licensed in
CA
In the registry since
2011
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Practice location Address checks out

3625 Martin Luther King Jr Blvd Ste 5
Lynwood, CA 90262-3509
Phone: (562) 508-8787
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 21395 (CA)

Record details

NPI number1558648550
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedNovember 4, 2011
Last updated in NPPESFebruary 3, 2020
Certification dateFebruary 3, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Addis Medical Group A Medical Corporation — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Lynwood