MEDICARE: DR. ROBERT WALTER HABERKORN 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	DC24813	CA

General Provider Information

NPI Number	:	1952592495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT WALTER HABERKORN DC

Provider Business Mailing Address
First Line	:	41555 COOK ST
Second Line	:	SUITE 160
City	:	PALM DESERT
State	:	CA
Zip	:	92211-5184
Country	:	US
Telephone Number	:	760-346-9400
Fax Number	:

Provider Business Practice Location Address
First Line	:	41555 COOK ST
Second Line	:	SUITE 160
City	:	PALM DESERT
State	:	CA
Zip	:	92211-5184
Country	:	US
Telephone Number	:	760-346-9400
Fax Number	:

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

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	03/17/2011

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