MEDICARE: GARRETT WILCHEK 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	DC27886	CA

General Provider Information

NPI Number	:	1851326995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARRETT WILCHEK D.C.

Provider Business Mailing Address
First Line	:	PO BOX 364
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-0364
Country	:	US
Telephone Number	:	714-375-4800
Fax Number	:	714-375-4801

Provider Business Practice Location Address
First Line	:	17822 BEACH BLVD STE 100
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-7161
Country	:	US
Telephone Number	:	714-375-4800
Fax Number	:	714-375-4801

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	03/12/2009

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