Provider Demographics
NPI:1568035970
Name:MANGAT CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:MANGAT CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGAT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-795-2700
Mailing Address - Street 1:6287 JARVIS AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1212
Mailing Address - Country:US
Mailing Address - Phone:510-795-2700
Mailing Address - Fax:
Practice Address - Street 1:6287 JARVIS AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-1212
Practice Address - Country:US
Practice Address - Phone:510-795-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty