Provider Demographics
NPI:1023318391
Name:MAGARIAN, GLENN ANTHONY (BS,DC)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:ANTHONY
Last Name:MAGARIAN
Suffix:
Gender:M
Credentials:BS,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11037 WARNER AVE
Mailing Address - Street 2:SUITE 333
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4007
Mailing Address - Country:US
Mailing Address - Phone:714-697-2225
Mailing Address - Fax:866-871-1460
Practice Address - Street 1:11037 WARNER AVE
Practice Address - Street 2:SUITE 333
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4007
Practice Address - Country:US
Practice Address - Phone:714-697-2225
Practice Address - Fax:866-871-1460
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor