MEDICARE: DR. MARLA JOANNE ROBERTSONTARPO 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	32234	CA

General Provider Information

NPI Number	:	1124386685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLA JOANNE ROBERTSONTARPO D.C.

Provider Business Mailing Address
First Line	:	23028 LAKE FOREST DR
Second Line	:	SUITE D
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1323
Country	:	US
Telephone Number	:	949-264-2613
Fax Number	:

Provider Business Practice Location Address
First Line	:	23028 LAKE FOREST DR
Second Line	:	SUITE D
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1323
Country	:	US
Telephone Number	:	949-264-2613
Fax Number	:

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

Provider Enumeration Date	:	05/02/2012
Last Update Date	:	08/31/2015

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