MEDICARE: ISABEL AMORIM 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	17264	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC0172640	OTHER	CA	BLUE SHIELD OF CALIFORNIA

General Provider Information

NPI Number	:	1730186107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABEL AMORIM D.C.

Provider Business Mailing Address
First Line	:	4156 BALDWIN AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-1708
Country	:	US
Telephone Number	:	626-443-2450
Fax Number	:	626-280-3092

Provider Business Practice Location Address
First Line	:	4156 BALDWIN AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-1708
Country	:	US
Telephone Number	:	626-443-2450
Fax Number	:	626-280-3092

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/08/2007

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