MEDICARE: DR. RONALD E TVEITMOE 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	18281	CA

General Provider Information

NPI Number	:	1780885699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD E TVEITMOE D.C.

Provider Business Mailing Address
First Line	:	412 LONGRIDGE DR
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94591-7558
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	448 VALLEY VIEW RD
Second Line	:	SUITE B
City	:	EL SOBRANTE
State	:	CA
Zip	:	94803-1636
Country	:	US
Telephone Number	:	510-734-4737
Fax Number	:

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	07/08/2007

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