MEDICARE: DR. FRED ALBERT HARKINS JR. DC

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	DC11917	CA

General Provider Information

NPI Number	:	1548230535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRED ALBERT HARKINS JR. DC

Provider Business Mailing Address
First Line	:	2819 W AVE K-12
Second Line	:	#178
City	:	LANCASTER
State	:	CA
Zip	:	93536
Country	:	US
Telephone Number	:	661-722-8147
Fax Number	:

Provider Business Practice Location Address
First Line	:	1672 W AVE J
Second Line	:	STE 204
City	:	LANCASTER
State	:	CA
Zip	:	93534-2861
Country	:	US
Telephone Number	:	661-948-2304
Fax Number	:

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	07/08/2007

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