MEDICARE: ANTHONY D SILECCHIO 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	DC27366	CA

General Provider Information

NPI Number	:	1659408953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY D SILECCHIO D.C.

Provider Business Mailing Address
First Line	:	4519 ALAMO ST
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-1734
Country	:	US
Telephone Number	:	805-584-1634
Fax Number	:	805-526-8200

Provider Business Practice Location Address
First Line	:	4519 ALAMO ST
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-1734
Country	:	US
Telephone Number	:	805-584-1634
Fax Number	:	805-526-8200

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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