MEDICARE: BUECHEL 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	DC26017	CA

General Provider Information

NPI Number	:	1164687257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUECHEL CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	4535 FANUEL ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-2904
Country	:	US
Telephone Number	:	858-866-6688
Fax Number	:	868-866-5644

Provider Business Practice Location Address
First Line	:	4535 FANUEL ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-2904
Country	:	US
Telephone Number	:	858-866-6688
Fax Number	:	868-866-5644

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MS. ELAINE LOPEZ
Credential	:
Telephone Number	:	858-866-6688

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	07/28/2008

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