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General NPI Number Information
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NPI Number | 1447382312
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Entity Type | Organization
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Legal Business Name | FARRIS,GARCIA,MANFRE,MELVIN CHIROPRACTIC INC.
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 19730 VENTURA BLVD SUITE 104
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2625
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Country | US
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Telephone | 818-710-0161
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Fax | 818-710-9327
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Provider Business Mailing Address
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Address Line | 19730 VENTURA BLVD SUITE 104
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2625
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Country | US
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Telephone | 818-710-0161
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Fax | 818-710-9327
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROD DAVID MELVIN
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Credential | D.C.
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Telephone | 818-710-0161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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