Provider Demographics
NPI:1427488162
Name:VERMA, MANITA (DC)
Entity type:Individual
Prefix:DR
First Name:MANITA
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MANITA
Other - Middle Name:
Other - Last Name:VERMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1 LEAGUE 61860
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-2138
Mailing Address - Country:US
Mailing Address - Phone:323-589-8804
Mailing Address - Fax:
Practice Address - Street 1:6522 PACIFIC BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4106
Practice Address - Country:US
Practice Address - Phone:323-589-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-15
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32408111N00000X, 111NN1001X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation