Provider Demographics
NPI:1548387202
Name:MANGURIAN, CHRISTINA VICTORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:VICTORIA
Last Name:MANGURIAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:SUITE 7M
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-5925
Mailing Address - Fax:415-206-8942
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:SUITE 7M
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-5925
Practice Address - Fax:415-206-8942
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2011-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2332642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry