MEDICARE: DR. JASON LESLIE ARNOLD 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	32418	CA

General Provider Information

NPI Number	:	1285985689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON LESLIE ARNOLD D.C.

Provider Business Mailing Address
First Line	:	183 E GLENARM ST
Second Line	:	SUITE 104
City	:	PASADENA
State	:	CA
Zip	:	91105-3460
Country	:	US
Telephone Number	:	626-799-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	183 E GLENARM ST
Second Line	:	SUITE 104
City	:	PASADENA
State	:	CA
Zip	:	91105-3460
Country	:	US
Telephone Number	:	626-799-4100
Fax Number	:

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

Provider Enumeration Date	:	09/25/2012
Last Update Date	:	09/25/2012

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