MEDICARE: DAVID AARON NICKLAS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC20332	CA

General Provider Information

NPI Number	:	1083656052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID AARON NICKLAS D.C.

Provider Business Mailing Address
First Line	:	935 RIVERSIDE AVE
Second Line	:	SUITE 2
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-2653
Country	:	US
Telephone Number	:	805-237-7463
Fax Number	:	805-237-7462

Provider Business Practice Location Address
First Line	:	935 RIVERSIDE AVE
Second Line	:	SUITE 2
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-2653
Country	:	US
Telephone Number	:	805-237-7463
Fax Number	:	805-237-7462

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	05/13/2024

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