MEDICARE: DR. CESAR O. QUINTANA 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	CH-10341	FL
2	111N00000X	Chiropractor	B01159	NV

General Provider Information

NPI Number	:	1538446984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CESAR O. QUINTANA D.C.

Provider Business Mailing Address
First Line	:	830 E CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-1512
Country	:	US
Telephone Number	:	702-384-8432
Fax Number	:	702-382-8191

Provider Business Practice Location Address
First Line	:	830 E CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-1512
Country	:	US
Telephone Number	:	702-384-8432
Fax Number	:	702-382-8191

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

Provider Enumeration Date	:	11/14/2011
Last Update Date	:	06/05/2013

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