Provider Demographics
NPI:1235322868
Name:SANDHU, MANJ SINGH (DC)
Entity Type:Individual
Prefix:
First Name:MANJ
Middle Name:SINGH
Last Name:SANDHU
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 1:4505 BARRANCA PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4707
Mailing Address - Country:US
Mailing Address - Phone:949-551-8002
Mailing Address - Fax:949-551-1281
Practice Address - Street 1:4505 BARRANCA PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4707
Practice Address - Country:US
Practice Address - Phone:949-551-8002
Practice Address - Fax:949-551-1281
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor