MEDICARE: DR. ADAM LEE SANDAHL 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	24587	CA

General Provider Information

NPI Number	:	1346309887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM LEE SANDAHL D.C.

Provider Business Mailing Address
First Line	:	6557 BRIGHT AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-4504
Country	:	US
Telephone Number	:	562-698-1515
Fax Number	:	562-698-3535

Provider Business Practice Location Address
First Line	:	6557 E PACIFIC COAST HWY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4202
Country	:	US
Telephone Number	:	562-430-8501
Fax Number	:	562-430-8591

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

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	06/02/2011

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