MEDICARE: DR. JAMES WILLIAM CHASE 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	DC0201410	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952342404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES WILLIAM CHASE D.C.

Provider Business Mailing Address
First Line	:	11625 PALM DR
Second Line	:	SUITE G
City	:	DESERT HOT SPRINGS
State	:	CA
Zip	:	92240-3629
Country	:	US
Telephone Number	:	760-251-3032
Fax Number	:	760-251-4703

Provider Business Practice Location Address
First Line	:	11625 PALM DR
Second Line	:	SUITE G
City	:	DESERT HOT SPRINGS
State	:	CA
Zip	:	92240-3629
Country	:	US
Telephone Number	:	760-251-3032
Fax Number	:	760-251-4703

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/11/2011

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