Healthcare Provider Details

I. General information

NPI: 1528261484
Provider Name (Legal Business Name): WAYNE SCHELLER CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231A S EL CAMINO REAL
OCEANSIDE CA
92054
US

IV. Provider business mailing address

2231A S EL CAMINO REAL
OCEANSIDE CA
92054
US

V. Phone/Fax

Practice location:
  • Phone: 760-722-9393
  • Fax: 760-722-2836
Mailing address:
  • Phone: 760-722-9393
  • Fax: 760-722-2836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 29002
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberDC29002
License Number StateCA

VIII. Authorized Official

Name: DR. WAYNE ROBERT SCHELLER
Title or Position: OWNER
Credential: DC
Phone: 760-722-9393