Healthcare Provider Details

I. General information

NPI: 1710147806
Provider Name (Legal Business Name): MAN TRAN CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5016 LANKERSHIM BLVD
NORTH HOLLYWOOD CA
91601-4222
US

IV. Provider business mailing address

5016 LANKERSHIM BLVD
NORTH HOLLYWOOD CA
91601-4222
US

V. Phone/Fax

Practice location:
  • Phone: 818-762-3155
  • Fax: 818-762-3157
Mailing address:
  • Phone: 818-762-3155
  • Fax: 818-762-3157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 27551
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 9372
License Number StateCA

VIII. Authorized Official

Name: DR. MAN TRAN
Title or Position: PRESIDENT
Credential: D.C., L.AC., PH.D.
Phone: 818-762-3155