MEDICARE: HAROLD ISEKE CHIROPRACTIC PROFESSIONAL CORPORATION

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

General Provider Information

NPI Number	:	1780120386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAROLD ISEKE CHIROPRACTIC PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	3711 LONG BEACH BLVD.
Second Line	:	SUITE 200
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3319
Country	:	US
Telephone Number	:	562-980-0055
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 LONG BEACH BLVD.
Second Line	:	SUITE 200
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3319
Country	:	US
Telephone Number	:	562-980-0055
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAROLD ISEKE
Credential	:	DC
Telephone Number	:	562-980-0555

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	01/13/2017

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