Provider Demographics
NPI:1487367322
Name:BRAR, MANPREET
Entity type:Individual
Prefix:
First Name:MANPREET
Middle Name:
Last Name:BRAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7759 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-2250
Mailing Address - Country:US
Mailing Address - Phone:424-901-3709
Mailing Address - Fax:
Practice Address - Street 1:7759 MASON AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-2250
Practice Address - Country:US
Practice Address - Phone:424-901-3709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician