Provider Demographics
NPI:1386811867
Name:GUAGLIANO, VINCE (DC)
Entity type:Individual
Prefix:DR
First Name:VINCE
Middle Name:
Last Name:GUAGLIANO
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 1:2407 N SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2913
Mailing Address - Country:US
Mailing Address - Phone:310-796-6955
Mailing Address - Fax:310-545-9588
Practice Address - Street 1:2407 N SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2913
Practice Address - Country:US
Practice Address - Phone:310-796-6955
Practice Address - Fax:310-545-9588
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor