Provider Demographics
NPI:1255676300
Name:MANN, RAHEEL ASHRAF (D,C)
Entity Type:Individual
Prefix:
First Name:RAHEEL
Middle Name:ASHRAF
Last Name:MANN
Suffix:
Gender:M
Credentials:D,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3711
Mailing Address - Country:US
Mailing Address - Phone:559-781-3033
Mailing Address - Fax:559-781-3073
Practice Address - Street 1:4824 E BASELINE RD
Practice Address - Street 2:STE 140
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4676
Practice Address - Country:US
Practice Address - Phone:480-969-4040
Practice Address - Fax:480-830-9202
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8295111N00000X
AZ8295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor