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General NPI Number Information
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NPI Number | 1023624392
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Entity Type | Individual
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Provider Name | MANVIR TAKHAR
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Gender | Female
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 5489 SNELL AVE
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City | SAN JOSE
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State | CA
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Zip | 95123-1541
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Country | US
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Telephone | 408-893-0878
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Fax |
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Provider Business Mailing Address
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Address Line | 1812 PARK AVE APT 1
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City | SAN JOSE
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State | CA
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Zip | 95126-1630
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Country | US
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Telephone | 408-893-0878
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Fax | 408-893-0878
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC37226
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License Number State | CA
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