MEDICARE: 1 WORLD DME LLC

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	DC27051	CA

General Provider Information

NPI Number	:	1386940344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1 WORLD DME LLC

Provider Business Mailing Address
First Line	:	2910 STEVENS CREEK BLVD
Second Line	:	STE 209
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2015
Country	:	US
Telephone Number	:	408-261-0772
Fax Number	:	408-261-0766

Provider Business Practice Location Address
First Line	:	2910 STEVENS CREEK BLVD
Second Line	:	STE 209
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2015
Country	:	US
Telephone Number	:	408-261-0772
Fax Number	:	408-261-0766

Authorized Official
Title or Position	:	PARTNER
Name	:	TAREK ELCHAMI
Credential	:	DC, QME
Telephone Number	:	408-476-6344

Provider Enumeration Date	:	02/08/2011
Last Update Date	:	04/13/2011

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