MEDICARE: RONALD BADENER

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	19373	CA

General Provider Information

NPI Number	:	1043433824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD BADENER

Provider Business Mailing Address
First Line	:	4600 ALONZO AVE
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-4316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-2439
Country	:	US
Telephone Number	:	310-614-7399
Fax Number	:

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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Directions to “ RONALD BADENER ” Practice Location

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