Provider Demographics
NPI:1235202805
Name:SANGES, MAURIZIO C (DC)
Entity Type:Individual
Prefix:DR
First Name:MAURIZIO
Middle Name:C
Last Name:SANGES
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 1:2850 ARTESIA BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3413
Mailing Address - Country:US
Mailing Address - Phone:310-370-0371
Mailing Address - Fax:310-542-1488
Practice Address - Street 1:2850 ARTESIA BLVD STE 208
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3413
Practice Address - Country:US
Practice Address - Phone:310-370-0371
Practice Address - Fax:310-542-1488
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16849111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC16849Medicare ID - Type Unspecified