MEDICARE: HEALTH QUEST WELLNESS GROUP, INC.

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	DC-30481	CA

General Provider Information

NPI Number	:	1770727539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH QUEST WELLNESS GROUP, INC.

Provider Business Mailing Address
First Line	:	815 E COLORADO ST STE 250
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-4510
Country	:	US
Telephone Number	:	818-246-3600
Fax Number	:	818-246-3604

Provider Business Practice Location Address
First Line	:	815 E COLORADO ST STE 250
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-4510
Country	:	US
Telephone Number	:	818-246-3600
Fax Number	:	818-246-3604

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. ALFRED A BAGRYAN
Credential	:	D.C.
Telephone Number	:	818-500-8340

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	04/23/2009

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