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NPI Code Detail

MEDICARE: PCH CHIRO INC.

MEDICARE: PCH CHIRO 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
1111NR0200XRadiology Chiropractor24587CA
2111N00000XChiropractorDC24587CA

General Provider Information

NPI Number : 1093941387
Entity Type Code : Organization
Provider Name (Legal Business Name) : PCH CHIRO INC.
Provider Business Mailing Address
First Line : 6557 E. PCH H-10
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-4202
Country : US
Telephone Number : 562-430-8501
Fax Number : 562-430-8591
Provider Business Practice Location Address
First Line : 6557 E. PCH H-10
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-4202
Country : US
Telephone Number : 562-430-8501
Fax Number : 562-430-8591
Authorized Official
Title or Position : OWN/DOCTOR
Name : MR. ADAM L SANDAHL
Credential : DC
Telephone Number : 562-430-8501
Provider Enumeration Date : 06/01/2009
Last Update Date : 03/14/2014

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Directions to “PCH CHIRO INC. ” Practice Location

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