Provider Demographics
NPI:1003313883
Name:MANANIAN, GARIK (DC)
Entity Type:Individual
Prefix:DR
First Name:GARIK
Middle Name:
Last Name:MANANIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 THOMPSON CT
Mailing Address - Street 2:STE 9
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1652
Mailing Address - Country:US
Mailing Address - Phone:818-333-6952
Mailing Address - Fax:
Practice Address - Street 1:2032 THOMPSON CT
Practice Address - Street 2:STE 9
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1652
Practice Address - Country:US
Practice Address - Phone:818-333-6952
Practice Address - Fax:818-484-3163
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34154111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor