Provider Demographics
NPI:1548745870
Name:GARATTI, ANGELICA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELICA
Middle Name:
Last Name:GARATTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6991 WILD LUPINE RD
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9180
Mailing Address - Country:US
Mailing Address - Phone:626-840-4734
Mailing Address - Fax:
Practice Address - Street 1:3480 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6149
Practice Address - Country:US
Practice Address - Phone:323-582-5159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor