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NPI Code Detail

MEDICARE: DR. JERALD R HANNAH D.C.

MEDICARE:  DR. JERALD R HANNAH  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
1111N00000XChiropractor31836CA

General Provider Information

NPI Number : 1518263490
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JERALD R HANNAH D.C.
Provider Business Mailing Address
First Line : 1391 WOODSIDE RD
Second Line : SUITE 200
City : REDWOOD CITY
State : CA
Zip : 94061-3578
Country : US
Telephone Number : 650-365-7775
Fax Number :
Provider Business Practice Location Address
First Line : 1391 WOODSIDE RD
Second Line : SUITE 200
City : REDWOOD CITY
State : CA
Zip : 94061-3578
Country : US
Telephone Number : 650-365-7775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2011
Last Update Date : 02/09/2011

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Directions to “ DR. JERALD R HANNAH D.C.” Practice Location

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