MEDICARE: DR. DEMEIL BETOUSHANA 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	DC 26680	CA

General Provider Information

NPI Number	:	1003898511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEMEIL BETOUSHANA D.C

Provider Business Mailing Address
First Line	:	800 WAYSIDE DR
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95380-2614
Country	:	US
Telephone Number	:	209-667-7333
Fax Number	:	209-667-7755

Provider Business Practice Location Address
First Line	:	800 WAYSIDE DR
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95380-2614
Country	:	US
Telephone Number	:	209-667-7333
Fax Number	:	209-667-7755

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	05/19/2009

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Directions to “ DR. DEMEIL BETOUSHANA D.C” Practice Location

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