MEDICARE: RABO CHIROPRACTIC

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	DC29532	CA

General Provider Information

NPI Number	:	1972752764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RABO CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1764 SAN DIEGO AVE
Second Line	:	STE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-1987
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1764 SAN DIEGO AVE
Second Line	:	STE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-1987
Country	:	US
Telephone Number	:	619-298-0800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DINA RABO
Credential	:	D.C.
Telephone Number	:	619-298-0800

Provider Enumeration Date	:	09/16/2008
Last Update Date	:	09/16/2008

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Directions to “RABO CHIROPRACTIC ” Practice Location

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