MEDICARE: DR. ALICIA ANDREIS PFLUEGER 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	21624	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21624	OTHER	CA	STATE BOARD LICENSE #

General Provider Information

NPI Number	:	1053481671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICIA ANDREIS PFLUEGER D.C.

Provider Business Mailing Address
First Line	:	1640 TIBURON BLVD
Second Line	:
City	:	TIBURON
State	:	CA
Zip	:	94920-2515
Country	:	US
Telephone Number	:	415-435-7420
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 TIBURON BLVD
Second Line	:
City	:	TIBURON
State	:	CA
Zip	:	94920-2515
Country	:	US
Telephone Number	:	415-435-7420
Fax Number	:

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/08/2007

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