MEDICARE: ARANIBAR CHIROPRACTIC CARE, 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	DC29421	CA

General Provider Information

NPI Number	:	1629358007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARANIBAR CHIROPRACTIC CARE, INC

Provider Business Mailing Address
First Line	:	931 SAN BRUNO AVE W RM 7
Second Line	:
City	:	SAN BRUNO
State	:	CA
Zip	:	94066-3435
Country	:	US
Telephone Number	:	650-225-0540
Fax Number	:	650-225-0510

Provider Business Practice Location Address
First Line	:	931 SAN BRUNO AVE W RM 7
Second Line	:
City	:	SAN BRUNO
State	:	CA
Zip	:	94066-3435
Country	:	US
Telephone Number	:	650-225-0540
Fax Number	:	650-225-0510

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DAWNA BROUQUA
Credential	:
Telephone Number	:	650-225-0540

Provider Enumeration Date	:	08/17/2011
Last Update Date	:	08/17/2011

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