MEDICARE: DR. AMANDA MARIE WARD N.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	ND-273	CA

General Provider Information

NPI Number	:	1164605606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA MARIE WARD N.D.

Provider Business Mailing Address
First Line	:	264 N COAST HIGHWAY 101
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-3254
Country	:	US
Telephone Number	:	760-230-4982
Fax Number	:	760-239-6068

Provider Business Practice Location Address
First Line	:	3978 SORRENTO VALLEY BLVD STE 310
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1436
Country	:	US
Telephone Number	:	760-230-4982
Fax Number	:	858-452-2501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	08/28/2012

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