MEDICARE: PUJAYANA CHIROPRACTIC INC

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	DC27517	CA
2	111N00000X	Chiropractor	DC25383	CA

General Provider Information

NPI Number	:	1881758258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUJAYANA CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	1017 FREMONT AVE STE A
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-3224
Country	:	US
Telephone Number	:	626-441-4888
Fax Number	:	626-441-5680

Provider Business Practice Location Address
First Line	:	1017 FREMONT AVE STE A
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-3224
Country	:	US
Telephone Number	:	626-441-4888
Fax Number	:	626-441-5680

Authorized Official
Title or Position	:	VP SECRETARY
Name	:	DR. CHRISTINE SUE SMITH
Credential	:	D.C.
Telephone Number	:	626-441-4888

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	08/22/2020

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