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General NPI Number Information
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NPI Number | 1285012161
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Entity Type | Individual
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Provider Name | PHILLIP WARD L.AC
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Gender | Male
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Dates
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Enumeration Date | 05/12/2015
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Last Update Date | 05/12/2015
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Provider Practice Location Address
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Address Line | 4241 REDWOOD AVE #2214
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City | LOS ANGELES
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State | CA
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Zip | 90066-5619
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Country | US
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Telephone | 323-376-2616
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Fax |
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Provider Business Mailing Address
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Address Line | 12153 VENTURA BLVD STE 104
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City | STUDIO CITY
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State | CA
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Zip | 91604-2507
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Country | US
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Telephone | 323-376-2616
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 16530
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License Number State | CA
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