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Individual
LARA A MANCHIK
Active
Individual
LARA A MANCHIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.C.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA15955
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA15955
—
CA
Enumeration date
07/03/2006
Last updated
02/18/2008
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