Provider Demographics
NPI:1093790958
Name:FRANCIS, MARVIN A (DC)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:A
Last Name:FRANCIS
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 1:9509 CENTRAL AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2400
Mailing Address - Country:US
Mailing Address - Phone:909-621-4944
Mailing Address - Fax:909-621-2163
Practice Address - Street 1:9509 CENTRAL AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2400
Practice Address - Country:US
Practice Address - Phone:909-621-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0208610Medicare ID - Type Unspecified