Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 34154 | CA |
NPI | 1003313883 |
---|---|
Provider Name | Dr. Garik Mananian |
First Address | Montrose, CA 91020-1652 |
Second Address | Montrose, CA 91020-1652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2018 |
Last Update Date | 03/05/2019 |