=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043634397
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT T. BELL, D.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2014
-----------------------------------------------------
Last Update Date | 02/06/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1199 E WALNUT ST STE 104
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91106-5164
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-792-4404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1199 E WALNUT ST STE 104
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91106-5164
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-792-4404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ROBERT T BELL
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 626-792-4404
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC14874
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------