Provider Demographics
NPI:1447382312
Name:FARRIS,GARCIA,MANFRE,MELVIN CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:FARRIS,GARCIA,MANFRE,MELVIN CHIROPRACTIC INC.
Other - Org Name:CORE CHIROPRACTIC GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MELVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-710-0161
Mailing Address - Street 1:19730 VENTURA BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2625
Mailing Address - Country:US
Mailing Address - Phone:818-710-0161
Mailing Address - Fax:818-710-9327
Practice Address - Street 1:19730 VENTURA BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2625
Practice Address - Country:US
Practice Address - Phone:818-710-0161
Practice Address - Fax:818-710-9327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty