Provider Demographics
NPI:1235270794
Name:MASANGKAY, EDGAR LACANLALE (DC)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:LACANLALE
Last Name:MASANGKAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22110 ROSCOE BLVD
Mailing Address - Street 2:#103
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-3845
Mailing Address - Country:US
Mailing Address - Phone:818-716-9924
Mailing Address - Fax:818-716-0017
Practice Address - Street 1:22110 ROSCOE BLVD
Practice Address - Street 2:#103
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-3845
Practice Address - Country:US
Practice Address - Phone:818-716-9924
Practice Address - Fax:818-716-0017
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-28263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor