MEDICARE: PARHAM 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	DC21772	CA

General Provider Information

NPI Number	:	1760563555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARHAM CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	15550 ROCKFIELD BLVD
Second Line	:	B220
City	:	IRVINE
State	:	CA
Zip	:	92618-2720
Country	:	US
Telephone Number	:	949-598-9999
Fax Number	:	949-598-9990

Provider Business Practice Location Address
First Line	:	27601 FORBES RD
Second Line	:	30
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1201
Country	:	US
Telephone Number	:	949-348-2522
Fax Number	:	949-348-2428

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	STEPHEN PARHAM
Credential	:	D.C.
Telephone Number	:	949-348-2522

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/19/2010

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