MEDICARE: BORSETH CHIROPRACTIC CENTER, 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	DC18338	CA

General Provider Information

NPI Number	:	1790085900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BORSETH CHIROPRACTIC CENTER, INC.

Provider Business Mailing Address
First Line	:	4849 RONSON COURT
Second Line	:	SUITE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1805
Country	:	US
Telephone Number	:	858-576-8181
Fax Number	:

Provider Business Practice Location Address
First Line	:	4849 RONSON COURT
Second Line	:	SUITE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1805
Country	:	US
Telephone Number	:	858-576-8181
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ELAINE BORSETH
Credential	:	DC
Telephone Number	:	858-576-8181

Provider Enumeration Date	:	10/22/2010
Last Update Date	:	10/22/2010

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