Healthcare Provider Details

I. General information

NPI: 1598757809
Provider Name (Legal Business Name): FORD SCOTT SEBASTIAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 ENCINITAS BLVD
ENCINITAS CA
92024-2845
US

IV. Provider business mailing address

280 N COAST HIGHWAY 101
ENCINITAS CA
92024-3254
US

V. Phone/Fax

Practice location:
  • Phone: 760-942-3321
  • Fax: 760-942-4468
Mailing address:
  • Phone: 760-942-3321
  • Fax: 760-942-4468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC20873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: