MEDICARE: MR. KEVIN M. FLEMING 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	DC 0270600	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HF591A	OTHER	CA	PTAN

General Provider Information

NPI Number	:	1346353141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEVIN M. FLEMING D.C.

Provider Business Mailing Address
First Line	:	PO BOX 646
Second Line	:
City	:	LOOMIS
State	:	CA
Zip	:	95650-0646
Country	:	US
Telephone Number	:	916-660-9923
Fax Number	:	916-660-9953

Provider Business Practice Location Address
First Line	:	24388 MAIN STREET
Second Line	:
City	:	FORESTHILL
State	:	CA
Zip	:	95631
Country	:	US
Telephone Number	:	530-367-2525
Fax Number	:	530-367-2525

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

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	02/23/2015

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