MEDICARE: DR. JOSEPH GARY LOJACONO 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
1	111N00000X	Chiropractor	DC23300	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC23300	OTHER	CA	BLUE CROSS
2	DC023300	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1275606402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH GARY LOJACONO D.C.

Provider Business Mailing Address
First Line	:	1830 SPRING ST
Second Line	:	SUITE A
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-1617
Country	:	US
Telephone Number	:	805-226-8001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1830 SPRING ST
Second Line	:	SUITE A
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-1617
Country	:	US
Telephone Number	:	805-226-8001
Fax Number	:

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/09/2007

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