MEDICARE: TAKAHASHI CHIROPRACTIC CORPORATION

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	DC25299	CA

General Provider Information

NPI Number	:	1184862351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAKAHASHI CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	11340 W. OYMPIC BLVD.
Second Line	:	SUITE 340
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1613
Country	:	US
Telephone Number	:	310-445-1050
Fax Number	:	310-445-1060

Provider Business Practice Location Address
First Line	:	11340 W. OLYMPIC BLVD.
Second Line	:	SUITE 340
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1613
Country	:	US
Telephone Number	:	310-445-1050
Fax Number	:	310-445-1060

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	BRANDON DAVID TAKAHASHI
Credential	:	D.C.
Telephone Number	:	310-445-1050

Provider Enumeration Date	:	01/27/2009
Last Update Date	:	01/27/2009

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Directions to “TAKAHASHI CHIROPRACTIC CORPORATION ” Practice Location

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