MEDICARE: TREANOR CHIROPRACTIC CORPORATION

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	DC14791	CA

General Provider Information

NPI Number	:	1477876175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREANOR CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	20301 SW ACACIA ST
Second Line	:	SUITE #150
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1732
Country	:	US
Telephone Number	:	949-660-0700
Fax Number	:	949-660-0756

Provider Business Practice Location Address
First Line	:	20301 SW ACACIA ST
Second Line	:	SUITE #150
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1732
Country	:	US
Telephone Number	:	949-660-0700
Fax Number	:	949-660-0756

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. ANDREA RENEA CATHCART
Credential	:
Telephone Number	:	949-660-0700

Provider Enumeration Date	:	03/09/2010
Last Update Date	:	03/09/2010

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