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NPI Code Detail

MEDICARE: DR. LYNN M. HAUSRATH D.C.

MEDICARE: DR. LYNN M. HAUSRATH 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
1111N00000XChiropractor17180CA

General Provider Information

NPI Number : 1134167778
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYNN M. HAUSRATH D.C.
Provider Business Mailing Address
First Line : 3919 MACDONALD AVE
Second Line :
City : RICHMOND
State : CA
Zip : 94805-2229
Country : US
Telephone Number : 510-236-4473
Fax Number : 510-236-0921
Provider Business Practice Location Address
First Line : 3919 MACDONALD AVE
Second Line :
City : RICHMOND
State : CA
Zip : 94805-2229
Country : US
Telephone Number : 510-236-4473
Fax Number : 510-236-0921
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 07/08/2007

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