MEDICARE: DR. NELSON SANTOS 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	18176	CA

General Provider Information

NPI Number	:	1932316494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NELSON SANTOS D.C.

Provider Business Mailing Address
First Line	:	100 W HIGH ST
Second Line	:	# 748
City	:	MOORPARK
State	:	CA
Zip	:	93021-1113
Country	:	US
Telephone Number	:	805-531-1188
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 NEW LOS ANGELES AVE
Second Line	:	STE 210
City	:	MOORPARK
State	:	CA
Zip	:	93021-2089
Country	:	US
Telephone Number	:	805-531-1188
Fax Number	:	805-531-1112

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	03/03/2022

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