MEDICARE: DR. PAUL EVANS 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	DC29687	CA

General Provider Information

NPI Number	:	1205840394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL EVANS DC

Provider Business Mailing Address
First Line	:	5480 PHILADELPHIA ST
Second Line	:	SUITE H
City	:	CHINO
State	:	CA
Zip	:	91710-2486
Country	:	US
Telephone Number	:	909-627-6884
Fax Number	:	909-627-5558

Provider Business Practice Location Address
First Line	:	5480 PHILADELPHIA ST
Second Line	:	SUITE H
City	:	CHINO
State	:	CA
Zip	:	91710-2486
Country	:	US
Telephone Number	:	909-627-6884
Fax Number	:	909-627-5558

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. PAUL EVANS DC” Practice Location

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