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NPI Code Detail

MEDICARE: DR. SCOTT ALAN DUBRUL I D.C.

MEDICARE: DR. SCOTT ALAN DUBRUL I 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
1111N00000XChiropractor22650CA

General Provider Information

NPI Number : 1174521231
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT ALAN DUBRUL I D.C.
Provider Business Mailing Address
First Line : 1422 MONTEREY ST
Second Line : A201
City : SAN LUIS OBISPO
State : CA
Zip : 93401-2944
Country : US
Telephone Number : 805-781-9155
Fax Number : 805-781-0141
Provider Business Practice Location Address
First Line : 1422 MONTEREY ST
Second Line : A201
City : SAN LUIS OBISPO
State : CA
Zip : 93401-2944
Country : US
Telephone Number : 805-781-9155
Fax Number : 805-781-0141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 07/25/2011

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