Individual
BRIAN MANAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-7890
Mailing address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-7890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA64856
CA
Other
Enumeration date
02/02/2024
Last updated
08/15/2025
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