MEDICARE: DR. CHRISTOPHER T. WATKINS 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	DC28869	CA
2	111NR0200X	Radiology Chiropractor	DC28869	CA

General Provider Information

NPI Number	:	1720153307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER T. WATKINS D.C.

Provider Business Mailing Address
First Line	:	1645 FULLERTON RD
Second Line	:
City	:	LA HABRA HEIGHTS
State	:	CA
Zip	:	90631-8413
Country	:	US
Telephone Number	:	562-691-9887
Fax Number	:	562-691-9887

Provider Business Practice Location Address
First Line	:	1645 FULLERTON RD
Second Line	:
City	:	LA HABRA HEIGHTS
State	:	CA
Zip	:	90631-8413
Country	:	US
Telephone Number	:	562-691-9887
Fax Number	:	562-691-9887

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	03/03/2009

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