MEDICARE: DR. JOSE SANTANA REYES 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	DC28154	CA

General Provider Information

NPI Number	:	1013910447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE SANTANA REYES D.C.

Provider Business Mailing Address
First Line	:	1999 EDISON HWY
Second Line	:	SUITES 2,4, 6
City	:	BAKERSFIELD
State	:	CA
Zip	:	93305-5554
Country	:	US
Telephone Number	:	661-861-9266
Fax Number	:	661-861-9222

Provider Business Practice Location Address
First Line	:	1999 EDISON HWY
Second Line	:	SUITES 2,4, 6
City	:	BAKERSFIELD
State	:	CA
Zip	:	93305-5554
Country	:	US
Telephone Number	:	661-861-9266
Fax Number	:	661-861-9222

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	01/30/2008

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