MEDICARE: DR. JASON GRANEY 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	DC25444	CA

General Provider Information

NPI Number	:	1639252844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON GRANEY DC

Provider Business Mailing Address
First Line	:	4690 NEBO DR
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-5233
Country	:	US
Telephone Number	:	619-460-2224
Fax Number	:	619-460-2226

Provider Business Practice Location Address
First Line	:	4690 NEBO DR
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-5233
Country	:	US
Telephone Number	:	619-460-2224
Fax Number	:	619-460-2226

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	01/14/2022

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Directions to “ DR. JASON GRANEY DC” Practice Location

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