MEDICARE: REZA SHAKERI 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	DC25929	CA

General Provider Information

NPI Number	:	1659435212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REZA SHAKERI D.C.

Provider Business Mailing Address
First Line	:	7011 N HOWARD ST STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2955
Country	:	US
Telephone Number	:	559-267-2700
Fax Number	:	559-261-0333

Provider Business Practice Location Address
First Line	:	7011 N HOWARD ST STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2955
Country	:	US
Telephone Number	:	559-267-2700
Fax Number	:	559-261-0333

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	07/09/2007

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Directions to “ REZA SHAKERI D.C.” Practice Location

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