MEDICARE: PAMELA DANIELS CH

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	25229	CA

General Provider Information

NPI Number	:	1760582043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA DANIELS CH

Provider Business Mailing Address
First Line	:	1165 PARK AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-2922
Country	:	US
Telephone Number	:	408-292-9765
Fax Number	:	408-292-9766

Provider Business Practice Location Address
First Line	:	1165 PARK AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-2922
Country	:	US
Telephone Number	:	408-292-9765
Fax Number	:	408-292-9766

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	04/05/2013

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Directions to “ PAMELA DANIELS CH” Practice Location

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