MEDICARE: DR. PETER JOHN CHANGARIS 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	13482	CA

General Provider Information

NPI Number	:	1982708376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER JOHN CHANGARIS D.C.

Provider Business Mailing Address
First Line	:	3720 GRASS VALLEY HWY
Second Line	:
City	:	AUBURN
State	:	CA
Zip	:	95602
Country	:	US
Telephone Number	:	916-717-4133
Fax Number	:	530-673-9148

Provider Business Practice Location Address
First Line	:	3720 GRASS VALLEY
Second Line	:
City	:	AUBURN
State	:	CA
Zip	:	95602
Country	:	US
Telephone Number	:	916-717-4133
Fax Number	:	530-673-9148

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	12/27/2016

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