MEDICARE: TICHENOR LOWMAN MILLER MEDICAL GROUP INC

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	207XS0106X	Orthopaedic Hand Surgery Physician	A70356	CA
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	A70356	CA
3	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	A70356	CA
4	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	A70356	CA
5	207XX0801X	Orthopaedic Trauma Physician	A70356	CA
6	2080P0006X	Developmental - Behavioral Pediatrics Physician	A70356	CA
7	207XP3100X	Pediatric Orthopaedic Surgery Physician	A70356	CA

General Provider Information

NPI Number	:	1801991963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TICHENOR LOWMAN MILLER MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	PO BOX 1354
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90801-1354
Country	:	US
Telephone Number	:	562-933-0249
Fax Number	:	562-933-3747

Provider Business Practice Location Address
First Line	:	1760 TERMINO AVE
Second Line	:	SUITE 308
City	:	LONG BEACH
State	:	CA
Zip	:	90804-2105
Country	:	US
Telephone Number	:	562-933-0249
Fax Number	:	562-933-3747

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TORIN CUNNINGHAM
Credential	:	M.D.
Telephone Number	:	562-933-0249

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	04/18/2011

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