MEDICARE: DR. JOB J ASAD D.C., B.SC

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	111NS0005X	Sports Physician Chiropractor	34521	CA

General Provider Information

NPI Number	:	1669747143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOB J ASAD D.C., B.SC

Provider Business Mailing Address
First Line	:	1280 BOULEVARD WAY
Second Line	:	SUITE 106
City	:	WALNUT CREEK
State	:	CA
Zip	:	94595-1125
Country	:	US
Telephone Number	:	925-289-8011
Fax Number	:

Provider Business Practice Location Address
First Line	:	1280 BOULEVARD WAY
Second Line	:	SUITE 106
City	:	WALNUT CREEK
State	:	CA
Zip	:	94595-1125
Country	:	US
Telephone Number	:	925-289-8011
Fax Number	:

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

Provider Enumeration Date	:	03/15/2012
Last Update Date	:	03/15/2012

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