MEDICARE: DR. THOMAS HADJIYANE 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	17167	CA

General Provider Information

NPI Number	:	1891795530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS HADJIYANE DC

Provider Business Mailing Address
First Line	:	2718 SANTA BARBARA AVE
Second Line	:	STE. 107-A
City	:	CAYUCOS
State	:	CA
Zip	:	93430-1471
Country	:	US
Telephone Number	:	805-543-8199
Fax Number	:

Provider Business Practice Location Address
First Line	:	1264 HIGUERA ST
Second Line	:	STE. 107-A
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-3124
Country	:	US
Telephone Number	:	805-543-8199
Fax Number	:

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	09/19/2016

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