| NPI | 1942571047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA MANVELYAN President 626-398-4069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A55018) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E3953) |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2012-01-20 |