MEDICARE: R. MARINARO CHIROPRACTIC CORP.

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	DC16717	CA

General Provider Information

NPI Number	:	1336322841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R. MARINARO CHIROPRACTIC CORP.

Provider Business Mailing Address
First Line	:	12215 VENTURA BLVD
Second Line	:	SUITE 208
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2533
Country	:	US
Telephone Number	:	818-505-0816
Fax Number	:	818-505-8623

Provider Business Practice Location Address
First Line	:	12215 VENTURA BLVD
Second Line	:	SUITE 208
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2533
Country	:	US
Telephone Number	:	818-505-0816
Fax Number	:	818-505-8623

Authorized Official
Title or Position	:	PRES.
Name	:	DR. RONALD MARINARO
Credential	:	D.C.
Telephone Number	:	818-505-0816

Provider Enumeration Date	:	12/07/2007
Last Update Date	:	12/07/2007

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