MEDICARE: DR. PAUL GASPER 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	DC20593	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC20593	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1679740856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL GASPER D. C.

Provider Business Mailing Address
First Line	:	1809 E DYER RD
Second Line	:	SUITE 311
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5740
Country	:	US
Telephone Number	:	949-863-0022
Fax Number	:

Provider Business Practice Location Address
First Line	:	29229 CANWOOD ST
Second Line	:	SUITE 205
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1561
Country	:	US
Telephone Number	:	310-649-5894
Fax Number	:

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

Provider Enumeration Date	:	05/15/2008
Last Update Date	:	05/15/2008

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