MEDICARE: MICHAEL ANTHONY DELFIN

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	34486	CA

General Provider Information

NPI Number	:	1538725247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ANTHONY DELFIN

Provider Business Mailing Address
First Line	:	342 QUINCY AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90814-3059
Country	:	US
Telephone Number	:	562-706-6260
Fax Number	:

Provider Business Practice Location Address
First Line	:	148 MAIN ST STE G
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-6386
Country	:	US
Telephone Number	:	562-706-6260
Fax Number	:

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

Provider Enumeration Date	:	05/17/2019
Last Update Date	:	07/30/2019

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