MEDICARE: AGNEW FAMILY 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

General Provider Information

NPI Number	:	1700462983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGNEW FAMILY CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	15520 ROCKFIELD BLVD
Second Line	:	STE A200
City	:	IRVINE
State	:	CA
Zip	:	92618-6705
Country	:	US
Telephone Number	:	949-598-9999
Fax Number	:	949-598-9990

Provider Business Practice Location Address
First Line	:	2535 JUDAH STREET
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-1437
Country	:	US
Telephone Number	:	415-702-6755
Fax Number	:	415-520-0259

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	LAURA AGNEW
Credential	:	D.C.
Telephone Number	:	415-702-6755

Provider Enumeration Date	:	03/19/2021
Last Update Date	:	03/19/2021

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