MEDICARE: DR. JEFFREY SCOTT MCCOMBS DC

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	DC 21428	CA

General Provider Information

NPI Number	:	1205105061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY SCOTT MCCOMBS DC

Provider Business Mailing Address
First Line	:	12821 CORAL TREE PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-7018
Country	:	US
Telephone Number	:	310-827-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	12821 CORAL TREE PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-7018
Country	:	US
Telephone Number	:	310-827-1030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2011
Last Update Date	:	12/23/2011

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