MEDICARE: DR. MICHAEL J BIRNBAUM 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	DC22287	CA

General Provider Information

NPI Number	:	1780891622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J BIRNBAUM D.C.

Provider Business Mailing Address
First Line	:	5819 E 2ND ST # 616
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5050
Country	:	US
Telephone Number	:	949-275-2368
Fax Number	:	562-433-1077

Provider Business Practice Location Address
First Line	:	5819 E 2ND ST # 616
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5050
Country	:	US
Telephone Number	:	949-275-2368
Fax Number	:	562-433-1077

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	06/18/2013

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