MEDICARE: DR. TRAM TRAN SOTELO D.C., L.AC., MAOM

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	30533	CA
2	171100000X	Acupuncturist	AC12448	CA

General Provider Information

NPI Number	:	1851505143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRAM TRAN SOTELO D.C., L.AC., MAOM

Provider Business Mailing Address
First Line	:	PO BOX 7194
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93006-7194
Country	:	US
Telephone Number	:	805-643-7899
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S A ST
Second Line	:	SUITE 200
City	:	OXNARD
State	:	CA
Zip	:	93030-5717
Country	:	US
Telephone Number	:	805-240-1800
Fax Number	:

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	12/18/2008

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