MEDICARE: DR. MICHAEL S MAIER DC

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	DC24492	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC0244920	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1043375678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL S MAIER DC

Provider Business Mailing Address
First Line	:	PO BOX 1109
Second Line	:
City	:	FALL RIVER MILLS
State	:	CA
Zip	:	96028-1109
Country	:	US
Telephone Number	:	530-336-6547
Fax Number	:	530-336-6547

Provider Business Practice Location Address
First Line	:	43123 HWY 299 E
Second Line	:
City	:	FALL RIVER MILLS
State	:	CA
Zip	:	96028-1109
Country	:	US
Telephone Number	:	530-336-6547
Fax Number	:	530-336-6547

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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