MEDICARE: TYLER BIGENHO 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	34563	CA

General Provider Information

NPI Number	:	1841859261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER BIGENHO DC

Provider Business Mailing Address
First Line	:	9611 CLEARBROOK DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-8020
Country	:	US
Telephone Number	:	714-227-1125
Fax Number	:

Provider Business Practice Location Address
First Line	:	4121 WESTERLY PL STE 115
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2341
Country	:	US
Telephone Number	:	714-227-1125
Fax Number	:	949-209-0349

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

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	09/22/2020

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Directions to “ TYLER BIGENHO DC” Practice Location

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