Provider Demographics
NPI:1104245463
Name:MANAS, BRIAN (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:MANAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ODYSSEY STE 165
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3194
Mailing Address - Country:US
Mailing Address - Phone:949-878-3511
Mailing Address - Fax:949-313-7234
Practice Address - Street 1:22 ODYSSEY STE 165
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3194
Practice Address - Country:US
Practice Address - Phone:949-878-3511
Practice Address - Fax:949-313-7234
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32909111NR0400X, 111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician