=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619993805
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARY C RAMSDEN DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2006
-----------------------------------------------------
Last Update Date | 01/06/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1588 S MISSION RD STE 115
-----------------------------------------------------
City | FALLBROOK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92028-4112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-322-6533
-----------------------------------------------------
Fax | 562-594-6009
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1588 S MISSION RD STE 115
-----------------------------------------------------
City | FALLBROOK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92028-4112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-728-9229
-----------------------------------------------------
Fax | 760-728-8098
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC11090
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------