MEDICARE: DR. LYNN KEREW DC, MPH

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	24153	CA

General Provider Information

NPI Number	:	1770666778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN KEREW DC, MPH

Provider Business Mailing Address
First Line	:	PO BOX 251736
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-9125
Country	:	US
Telephone Number	:	310-399-0337
Fax Number	:	310-399-3944

Provider Business Practice Location Address
First Line	:	3435 OCEAN PARK BLVD STE 101
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-3316
Country	:	US
Telephone Number	:	310-399-0337
Fax Number	:	310-399-3944

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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