Individual
DAVIE MARVAN MANULLANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1725 W 17TH ST, SANTA ANA, CA 92706-2316
(951) 858-7902
Mailing address
3775 NELSON ST, CORONA, CA 92881-0602
(951) 858-7902
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95173934
CA
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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