MEDICARE: TIFFANY CROUCH 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	32918	CA

General Provider Information

NPI Number	:	1861898462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY CROUCH D.C.

Provider Business Mailing Address
First Line	:	1252 S LA VERNE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-3814
Country	:	US
Telephone Number	:	323-795-3060
Fax Number	:

Provider Business Practice Location Address
First Line	:	2637 E CARSON ST
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90810-1508
Country	:	US
Telephone Number	:	310-847-1321
Fax Number	:

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

Provider Enumeration Date	:	11/08/2014
Last Update Date	:	11/08/2014

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Directions to “ TIFFANY CROUCH D.C.” Practice Location

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