Healthcare Provider Details

I. General information

NPI: 1902974512
Provider Name (Legal Business Name): MICHAEL A. WARNER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 06/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23161 VENTURA BLVD SUITE 209
WOODLAND HILLS CA
91364-1105
US

IV. Provider business mailing address

23161 VENTURA BLVD SUITE 209
WOODLAND HILLS CA
91364-1105
US

V. Phone/Fax

Practice location:
  • Phone: 818-340-0834
  • Fax: 818-340-0983
Mailing address:
  • Phone: 818-340-0834
  • Fax: 818-340-0983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number17906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: