MEDICARE: JAMES E. ALVIS D.C., Q.M.E., A.M.E.

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	DC16240	CA
2	111NI0013X	Independent Medical Examiner Chiropractor	DC16240	CA

General Provider Information

NPI Number	:	1669651832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES E. ALVIS D.C., Q.M.E., A.M.E.

Provider Business Mailing Address
First Line	:	520 E FOOTHILL BLVD
Second Line	:	SUITE A
City	:	POMONA
State	:	CA
Zip	:	91767-1200
Country	:	US
Telephone Number	:	909-399-9696
Fax Number	:	909-399-0065

Provider Business Practice Location Address
First Line	:	520 E FOOTHILL BLVD
Second Line	:	SUITE A
City	:	POMONA
State	:	CA
Zip	:	91767-1200
Country	:	US
Telephone Number	:	909-399-9696
Fax Number	:	909-399-0065

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

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	10/24/2007

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