MEDICARE: DR. DEAN WINES 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	111N00000X	Chiropractor	DC0086720	CA

General Provider Information

NPI Number	:	1861525677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEAN WINES DC

Provider Business Mailing Address
First Line	:	550 MAPLE AVE
Second Line	:
City	:	BEAUMONT
State	:	CA
Zip	:	92223-2242
Country	:	US
Telephone Number	:	951-845-6611
Fax Number	:	951-845-6616

Provider Business Practice Location Address
First Line	:	550 MAPLE AVE
Second Line	:
City	:	BEAUMONT
State	:	CA
Zip	:	92223-2242
Country	:	US
Telephone Number	:	951-845-6611
Fax Number	:	951-845-6616

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/17/2012

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Directions to “ DR. DEAN WINES DC” Practice Location

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