MEDICARE: DR. CRAIG JOEL GELFOUND DC

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	111NS0005X	Sports Physician Chiropractor	23256	CA
2	111NX0100X	Occupational Health Chiropractor	23256	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23256	OTHER	CA	CARRIERS OTHER THAN BLUE

General Provider Information

NPI Number	:	1730260878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG JOEL GELFOUND DC

Provider Business Mailing Address
First Line	:	1629 WEST AVENUE J
Second Line	:	SUITE 101
City	:	LANCASTER
State	:	CA
Zip	:	93534-2850
Country	:	US
Telephone Number	:	661-942-3346
Fax Number	:	661-942-0886

Provider Business Practice Location Address
First Line	:	1629 WEST AVENUE J
Second Line	:	SUITE 101
City	:	LANCASTER
State	:	CA
Zip	:	93534-2850
Country	:	US
Telephone Number	:	661-942-3346
Fax Number	:	661-942-0886

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	09/11/2025

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