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General NPI Number Information
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NPI Number | 1073644811
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Entity Type | Individual
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Provider Name | GARY BRADFORD WRIGHT D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 11/29/2018
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Provider Practice Location Address
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Address Line | 50 S. ANAHEIM BLVD. #250
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City | ANAHEIM
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State | CA
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Zip | 92805-2960
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Country | US
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Telephone | 714-956-2225
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Fax | 714-956-5350
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Provider Business Mailing Address
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Address Line | 50 S. ANAHEIM BLVD. #250
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City | ANAHEIM
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State | CA
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Zip | 92805-2960
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Country | US
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Telephone | 714-956-2225
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Fax | 714-956-5350
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC023059
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License Number State | CA
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