Healthcare Provider Details

I. General information

NPI: 1285552513
Provider Name (Legal Business Name): CHRISTIAN AARON OCTOMAN MANUEL DDS, DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16071 GOLDENWEST ST
HUNTINGTON BEACH CA
92647-3405
US

IV. Provider business mailing address

2451 ONEIDA ST UNIT B
PASADENA CA
91107-5258
US

V. Phone/Fax

Practice location:
  • Phone: 714-536-2383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: