MEDICARE: DR. MICHAEL P SIMMONS 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	11034	CA

General Provider Information

NPI Number	:	1801828462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL P SIMMONS D.C.

Provider Business Mailing Address
First Line	:	3800 WATT AVENUE
Second Line	:	SUITE 120
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2622
Country	:	US
Telephone Number	:	916-484-0321
Fax Number	:	916-481-6830

Provider Business Practice Location Address
First Line	:	3800 WATT AVENUE
Second Line	:	SUITE 120
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2622
Country	:	US
Telephone Number	:	916-484-0321
Fax Number	:	916-481-6830

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	09/03/2019

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