MEDICARE: KENT A SVENINGSON A 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	DC21528	CA

General Provider Information

NPI Number	:	1518038298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENT A SVENINGSON A CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	1100 S COAST HWY
Second Line	:	SUITE 215
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-2968
Country	:	US
Telephone Number	:	949-376-3030
Fax Number	:	949-376-3028

Provider Business Practice Location Address
First Line	:	1100 S COAST HWY
Second Line	:	SUITE 215
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-2968
Country	:	US
Telephone Number	:	949-376-3030
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. KENT ALAN SVENINGSON
Credential	:	D.C.
Telephone Number	:	949-376-3030

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/11/2010

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