MEDICARE: CHAMBERS CHIROPRACTIC CENTER, INC.

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	19077	CA

General Provider Information

NPI Number	:	1538433081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMBERS CHIROPRACTIC CENTER, INC.

Provider Business Mailing Address
First Line	:	2670 S WHITE RD
Second Line	:	SUITE 160
City	:	SAN JOSE
State	:	CA
Zip	:	95148-2071
Country	:	US
Telephone Number	:	408-270-8795
Fax Number	:	408-223-1970

Provider Business Practice Location Address
First Line	:	2670 S WHITE RD
Second Line	:	SUITE 160
City	:	SAN JOSE
State	:	CA
Zip	:	95148-2071
Country	:	US
Telephone Number	:	408-270-8795
Fax Number	:	408-223-1970

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. LAWRENCE D CHAMBERS
Credential	:	D.C.
Telephone Number	:	408-270-8795

Provider Enumeration Date	:	03/01/2012
Last Update Date	:	03/01/2012

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