MEDICARE: DR. PRICE CHIROPRACTIC INC

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	DC15537	CA
2	111N00000X	Chiropractor	DC12023	CA

General Provider Information

NPI Number	:	1700104585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. PRICE CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	5336 FOUNTAIN AVENUE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1005
Country	:	US
Telephone Number	:	323-467-5200
Fax Number	:	323-467-1952

Provider Business Practice Location Address
First Line	:	5336 FOUNTAIN AVENUE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1005
Country	:	US
Telephone Number	:	323-467-5200
Fax Number	:	323-467-1952

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	STEPHEN DON PRICE
Credential	:	D.C.
Telephone Number	:	323-467-5200

Provider Enumeration Date	:	05/04/2010
Last Update Date	:	02/04/2016

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