MEDICARE: CORTES-RING CHIROPRACTIC, INC.

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-28938	CA
2	111N00000X	Chiropractor	DC28156	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W17935	OTHER		MEDICARE PTAN

General Provider Information

NPI Number	:	1043392509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORTES-RING CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	7441 UNIVERSITY AVE
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-6004
Country	:	US
Telephone Number	:	619-464-1600
Fax Number	:	619-464-6546

Provider Business Practice Location Address
First Line	:	7441 UNIVERSITY AVE
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-6004
Country	:	US
Telephone Number	:	619-464-1600
Fax Number	:	619-464-6546

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. JEFFERY ROBERT RING
Credential	:	D.C.
Telephone Number	:	619-464-1600

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	10/21/2009

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Directions to “CORTES-RING CHIROPRACTIC, INC. ” Practice Location

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