MEDICARE: DR. GREGORY HERBERT WARD 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	011108	CA

General Provider Information

NPI Number	:	1407036684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY HERBERT WARD D.C.

Provider Business Mailing Address
First Line	:	933 VALE TERRACE DR STE C
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92084-5213
Country	:	US
Telephone Number	:	760-758-3214
Fax Number	:	760-945-0643

Provider Business Practice Location Address
First Line	:	933 VALE TERRACE DR STE C
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92084-5213
Country	:	US
Telephone Number	:	760-758-3214
Fax Number	:	760-945-0643

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

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/06/2007

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