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NPI Code Detail

MEDICARE: DR. JASON DENNIS REZANSOFF D.C.

MEDICARE:  DR. JASON DENNIS REZANSOFF  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
1111N00000XChiropractorDC27284CA

General Provider Information

NPI Number : 1700980976
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON DENNIS REZANSOFF D.C.
Provider Business Mailing Address
First Line : PO BOX 2671
Second Line : 31944 HILLTOP BLVD
City : RUNNING SPRINGS
State : CA
Zip : 92382-2671
Country : US
Telephone Number : 909-867-5547
Fax Number : 909-867-5487
Provider Business Practice Location Address
First Line : 31944 HILLTOP BLVD
Second Line :
City : RUNNING SPRINGS
State : CA
Zip : 92382-2671
Country : US
Telephone Number : 909-867-5547
Fax Number : 909-867-5487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JASON DENNIS REZANSOFF D.C.” Practice Location

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