MEDICARE: BARCLAY 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	DC31278	CA

General Provider Information

NPI Number	:	1124387949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARCLAY CHIROPRACTIC INC.

Provider Business Mailing Address
First Line	:	15550 ROCKFIELD BLVD
Second Line	:	B220
City	:	IRVINE
State	:	CA
Zip	:	92618-2720
Country	:	US
Telephone Number	:	949-598-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 E YORBA LINDA BLVD
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92870-3832
Country	:	US
Telephone Number	:	714-381-8458
Fax Number	:	714-364-1675

Authorized Official
Title or Position	:	OWNER
Name	:	DARON BARCLAY
Credential	:	D.C.
Telephone Number	:	949-598-9999

Provider Enumeration Date	:	05/14/2012
Last Update Date	:	05/14/2012

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