MEDICARE: DR. MICHAEL TERRENCE MCGHEE 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	111NS0005X	Sports Physician Chiropractor	22767	CA

General Provider Information

NPI Number	:	1982648952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL TERRENCE MCGHEE DC

Provider Business Mailing Address
First Line	:	225 WASHINGTON ST
Second Line	:	SUITE B-1
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-5975
Country	:	US
Telephone Number	:	408-274-7990
Fax Number	:	408-247-7990

Provider Business Practice Location Address
First Line	:	225 WASHINGTON ST
Second Line	:	SUITE B-1
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-5975
Country	:	US
Telephone Number	:	408-274-7990
Fax Number	:	408-247-7990

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	07/08/2007

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