MEDICARE: DR. DON P WRIGHT 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	DC29387	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC29387	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1629071410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DON P WRIGHT D.C.

Provider Business Mailing Address
First Line	:	13746 VICTORY BLVD
Second Line	:	201
City	:	VAN NUYS
State	:	CA
Zip	:	91401-6716
Country	:	US
Telephone Number	:	818-988-3341
Fax Number	:	818-988-3343

Provider Business Practice Location Address
First Line	:	13746 VICTORY BLVD
Second Line	:	201
City	:	VAN NUYS
State	:	CA
Zip	:	91401-6716
Country	:	US
Telephone Number	:	818-988-3341
Fax Number	:	818-988-3343

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	02/28/2008

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