MEDICARE: DR. RONALD S. ZECHA 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	28605	CA

General Provider Information

NPI Number	:	1427252121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD S. ZECHA D.C.

Provider Business Mailing Address
First Line	:	667 PALM AVE
Second Line	:	SUITE A
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1243
Country	:	US
Telephone Number	:	619-575-8887
Fax Number	:	619-575-1374

Provider Business Practice Location Address
First Line	:	667 PALM AVE
Second Line	:	SUITE A
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1243
Country	:	US
Telephone Number	:	619-575-8887
Fax Number	:	619-575-1374

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

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	10/19/2012

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