MEDICARE: DR. CHRISTOPHER MANUEL CLEVELAND 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	111NR0400X	Rehabilitation Chiropractor	DC27977	CA
2	111NS0005X	Sports Physician Chiropractor	DC27977	CA
3	111NX0100X	Occupational Health Chiropractor	DC27977	CA
4	111NX0800X	Orthopedic Chiropractor	DC27977	CA

General Provider Information

NPI Number	:	1811148943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MANUEL CLEVELAND D.C.

Provider Business Mailing Address
First Line	:	801 S FLOWER ST
Second Line	:	SUITE# 204
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-4625
Country	:	US
Telephone Number	:	213-481-7026
Fax Number	:	213-623-9985

Provider Business Practice Location Address
First Line	:	801 S FLOWER ST
Second Line	:	SUITE# 204
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-4625
Country	:	US
Telephone Number	:	213-481-7026
Fax Number	:	213-623-9985

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

Provider Enumeration Date	:	10/07/2008
Last Update Date	:	10/07/2008

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