MEDICARE: DR. CYNTHIA BURKHARDT DC

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	DC21648	CA

General Provider Information

NPI Number	:	1780785089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA BURKHARDT DC

Provider Business Mailing Address
First Line	:	11274 LOS ALAMITOS BLVD
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:	562-598-2923
Fax Number	:	562-431-3263

Provider Business Practice Location Address
First Line	:	11274 LOS ALAMITOS BLVD
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:	562-598-2923
Fax Number	:	562-431-3263

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	01/24/2012

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