MEDICARE: DR. WAYNE R SCHELLER D.C.

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	111N00000X	Chiropractor	DC29002	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC02900200	OTHER	CA	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1447252267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE R SCHELLER D.C.

Provider Business Mailing Address
First Line	:	2124 S EL CAMINO REAL
Second Line	:	STE 101
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6211
Country	:	US
Telephone Number	:	760-722-9393
Fax Number	:	760-722-2836

Provider Business Practice Location Address
First Line	:	2124 S EL CAMINO REAL
Second Line	:	STE 101
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6211
Country	:	US
Telephone Number	:	760-722-9393
Fax Number	:	760-722-2836

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	11/20/2018

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