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NPI Code Detail

MEDICARE: PHILIP D RAKE CHIROPRACTIC INC

MEDICARE: PHILIP D RAKE 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
1111NX0800XOrthopedic Chiropractor15357CA

General Provider Information

NPI Number : 1154303527
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILIP D RAKE CHIROPRACTIC INC
Provider Business Mailing Address
First Line : 2048 MONTROSE AVE
Second Line :
City : MONTROSE
State : CA
Zip : 91020-1605
Country : US
Telephone Number : 818-249-8326
Fax Number : 818-352-1105
Provider Business Practice Location Address
First Line : 2048 MONTROSE AVE
Second Line :
City : MONTROSE
State : CA
Zip : 91020-1605
Country : US
Telephone Number : 818-249-8326
Fax Number : 818-352-1105
Authorized Official
Title or Position : DOCTOR/PRESIDENT
Name : DR. PHILIP DAVID RAKE
Credential : D.C.
Telephone Number : 818-249-8326
Provider Enumeration Date : 11/18/2005
Last Update Date : 04/24/2012

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Directions to “PHILIP D RAKE CHIROPRACTIC INC ” Practice Location

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