MEDICARE: HAMED MADANI DC PC

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	3936	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205290509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMED MADANI DC PC

Provider Business Mailing Address
First Line	:	598 E 13TH AVE STE B
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-4783
Country	:	US
Telephone Number	:	541-762-1777
Fax Number	:	541-762-1776

Provider Business Practice Location Address
First Line	:	598 E 13TH AVE STE B
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-4783
Country	:	US
Telephone Number	:	541-762-1777
Fax Number	:	541-762-1776

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	HAMED MADANI
Credential	:	DC
Telephone Number	:	541-762-1777

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	04/12/2016

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Directions to “HAMED MADANI DC PC ” Practice Location

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