MEDICARE: TYLER JONES DC

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	33985	CA
2	111NX0100X	Occupational Health Chiropractor	33985	CA
3	111NR0400X	Rehabilitation Chiropractor	33985	CA

General Provider Information

NPI Number	:	1831614379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER JONES DC

Provider Business Mailing Address
First Line	:	25255 CABOT RD STE 110
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5507
Country	:	US
Telephone Number	:	949-380-7215
Fax Number	:

Provider Business Practice Location Address
First Line	:	25255 CABOT RD STE 110
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5507
Country	:	US
Telephone Number	:	949-380-7215
Fax Number	:

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

Provider Enumeration Date	:	08/05/2017
Last Update Date	:	08/05/2017

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Directions to “ TYLER JONES DC” Practice Location

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