MEDICARE: DR. TINA M. HABHAB 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	7364	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0402840	OTHER	AZ	BCBS

General Provider Information

NPI Number	:	1649462870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA M. HABHAB DC

Provider Business Mailing Address
First Line	:	8390 E VIA DEVENTURA
Second Line	:	STE F110 #160
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-3189
Country	:	US
Telephone Number	:	480-220-5298
Fax Number	:

Provider Business Practice Location Address
First Line	:	7349 N VIA PASEO DEL SUR
Second Line	:	STE 530
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-3765
Country	:	US
Telephone Number	:	480-220-5298
Fax Number	:

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

Provider Enumeration Date	:	08/12/2007
Last Update Date	:	03/30/2017

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