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General NPI Number Information
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NPI Number | 1790293140
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Entity Type | Organization
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Legal Business Name | OLSEN MANALASTAS CHIROPRACTIC INC.
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Dates
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Enumeration Date | 01/19/2018
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Last Update Date | 01/19/2018
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Provider Practice Location Address
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Address Line | 2499 S BARRINGTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90064-2938
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Country | US
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Telephone | 310-231-7401
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Fax |
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Provider Business Mailing Address
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Address Line | 2499 S BARRINGTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90064-2938
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Country | US
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Telephone | 310-231-7401
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. BRIAN GABRIEL MANALASTAS
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Credential | DC
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Telephone | 310-231-7401
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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 | DC33948
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License Number State | CA
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