MEDICARE: PAUL PICHA 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	30876	CA

General Provider Information

NPI Number	:	1942452941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL PICHA D.C.

Provider Business Mailing Address
First Line	:	134 CITY LIMITS CIR
Second Line	:
City	:	EMERYVILLE
State	:	CA
Zip	:	94608-1051
Country	:	US
Telephone Number	:	510-735-1974
Fax Number	:

Provider Business Practice Location Address
First Line	:	1905 FRANKLIN ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-2905
Country	:	US
Telephone Number	:	510-735-1974
Fax Number	:

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

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	12/18/2008

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