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NPI Code Detail

MEDICARE: WESTSIDE CHIROPRACTIC

MEDICARE: WESTSIDE CHIROPRACTIC
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
1111N00000XChiropractorDC25468CA

General Provider Information

NPI Number : 1972759488
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTSIDE CHIROPRACTIC
Provider Business Mailing Address
First Line : 190 W 25TH AVE STE 4
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-2272
Country : US
Telephone Number : 650-349-2222
Fax Number : 650-341-3415
Provider Business Practice Location Address
First Line : 190 W 25TH AVE STE 4
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-2272
Country : US
Telephone Number : 650-349-2222
Fax Number : 650-341-3415
Authorized Official
Title or Position : CHIROPRACTOR
Name : MICHAEL LUDOVICO
Credential : D.C.
Telephone Number : 650-349-2222
Provider Enumeration Date : 08/15/2008
Last Update Date : 12/21/2011

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Directions to “WESTSIDE CHIROPRACTIC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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