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General NPI Number Information
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NPI Number | 1205925542
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Entity Type | Individual
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Provider Name | EMANUEL H BOTELHO D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 27699 JEFFERSON AVE STE 203
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City | TEMECULA
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State | CA
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Zip | 92590-2696
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Country | US
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Telephone | 951-587-0100
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Fax | 951-587-0101
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Provider Business Mailing Address
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Address Line | 744 S MORNINGSTAR DR
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City | ANAHEIM
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State | CA
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Zip | 92808-1632
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Country | US
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Telephone | 951-587-0100
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Fax | 951-587-0101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 31969
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License Number State | CA
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