MEDICARE: DR. ADRIAN EDWARD PUJAYANA 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	DC27517	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ05199Z	OTHER	CA	BLUE SHIELD GROUP NO

General Provider Information

NPI Number	:	1730110685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIAN EDWARD PUJAYANA D.C.

Provider Business Mailing Address
First Line	:	1017 FREMONT AVE
Second Line	:	SUITE A
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-3224
Country	:	US
Telephone Number	:	626-441-4888
Fax Number	:	626-441-5680

Provider Business Practice Location Address
First Line	:	1017 FREMONT AVE
Second Line	:	SUITE A
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-3224
Country	:	US
Telephone Number	:	626-441-4888
Fax Number	:	626-441-5680

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/08/2007

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