.Haney Chiropracticpc.
Organization Active NPI Chiropractor · Madera, CA
NPI 1902868623 · NPPES record last updated Feb 22, 2012
Key facts
- NPI
- 1902868623
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC28490 (CA)
- Legal business name
- .HANEY CHIROPRACTICPC.
- Practice address
- 36734 Avenue 12
Madera, CA 93636-8774 - Phone
- (559) 660-5262
- Fax
- (559) 800-7072
- NPI assigned
- Apr 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Margaret Alyce Reese
- Title
- Office MGR
- Phone
- (559) 660-5262
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120521000305 | CA | Part B Supplier - Clinic/Group Practice | 5092978593 |
Receives reassigned benefits from 1 practitioner Practice locations: Madera, CA |
National Provider Directory
Locations
36734 Avenue 12
Madera, CA 93636
Phone (559) 660-5262
36754 Avenue 12
Ste 107
Madera, CA 93636
Phone (559) 660-5262
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | DC28490 | CA | Yes |
| Chiropractor |
111N00000X | DC28489 | CA |
Addresses
Primary practice location
36734 Avenue 12
Madera, CA 93636-8774
Mailing address
36734 Avenue 12
Madera, CA 93636-8774
Phone (559) 660-5262
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276058 | Other | PA | BLUE CROSS |
Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.