MEDICARE: DR. MARIE ANGELINE SZCZURAK 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 22870	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC22870	OTHER	CA	BOARD OF CHIROPRACTIC EXAMINERS

General Provider Information

NPI Number	:	1013174002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE ANGELINE SZCZURAK D.C.

Provider Business Mailing Address
First Line	:	5301 LAUREL CANYON BLVD
Second Line	:	#120
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-2736
Country	:	US
Telephone Number	:	310-854-4266
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 LAUREL CANYON BLVD
Second Line	:	#120
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-2736
Country	:	US
Telephone Number	:	310-854-4266
Fax Number	:

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

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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