MEDICARE: DR. ALICIA M LOAIZA 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	DC18528	CA

General Provider Information

NPI Number	:	1710900543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICIA M LOAIZA D.C.

Provider Business Mailing Address
First Line	:	27401 LOS ALTOS
Second Line	:	STE 300
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-7608
Country	:	US
Telephone Number	:	949-831-1932
Fax Number	:	949-831-1762

Provider Business Practice Location Address
First Line	:	27401 LOS ALTOS
Second Line	:	STE 300
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-7608
Country	:	US
Telephone Number	:	949-831-1932
Fax Number	:	949-831-1762

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	10/13/2016

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