Provider Demographics
NPI:1588008742
Name:MANN, CHRISTOPHER JAMES
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:MANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CHULA ST
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-4724
Mailing Address - Country:US
Mailing Address - Phone:626-205-0310
Mailing Address - Fax:
Practice Address - Street 1:13177 RAMONA BLVD
Practice Address - Street 2:
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706-3855
Practice Address - Country:US
Practice Address - Phone:626-962-6168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator