MEDICARE: DR. DAVID N SKINNER 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	24615	CA

General Provider Information

NPI Number	:	1790918993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID N SKINNER D.C.

Provider Business Mailing Address
First Line	:	24102 EL TORO RD
Second Line	:	SUITE D
City	:	LAGUNA WOODS
State	:	CA
Zip	:	92637-3123
Country	:	US
Telephone Number	:	949-581-9191
Fax Number	:	949-581-9192

Provider Business Practice Location Address
First Line	:	24102 EL TORO RD
Second Line	:	SUITE D
City	:	LAGUNA WOODS
State	:	CA
Zip	:	92637-3123
Country	:	US
Telephone Number	:	949-581-9191
Fax Number	:	949-581-9192

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

Provider Enumeration Date	:	09/03/2009
Last Update Date	:	09/03/2009

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