Provider Demographics
NPI:1932363363
Name:MALINVAUD CHIROPRACTIC CARE INC.
Entity Type:Organization
Organization Name:MALINVAUD CHIROPRACTIC CARE INC.
Other - Org Name:PROVENCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN-GUILLAUME
Authorized Official - Middle Name:
Authorized Official - Last Name:MALINVAUD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-380-0436
Mailing Address - Street 1:15477 VENTURA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3049
Mailing Address - Country:US
Mailing Address - Phone:818-380-0436
Mailing Address - Fax:818-380-0438
Practice Address - Street 1:15477 VENTURA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3049
Practice Address - Country:US
Practice Address - Phone:818-380-0436
Practice Address - Fax:818-380-0438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29510111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty