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NPI Code Detail

MEDICARE: DR. GARY T. WECKBACHER D.C.

MEDICARE:  DR. GARY T. WECKBACHER  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
1111NX0800XOrthopedic ChiropractorDC18169CA

General Provider Information

NPI Number : 1487685574
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY T. WECKBACHER D.C.
Provider Business Mailing Address
First Line : 2048 MONTROSE AVE
Second Line :
City : MONTROSE
State : CA
Zip : 91020-1605
Country : US
Telephone Number : 818-957-7612
Fax Number : 818-957-3756
Provider Business Practice Location Address
First Line : 2048 MONTROSE AVE
Second Line :
City : MONTROSE
State : CA
Zip : 91020-1605
Country : US
Telephone Number : 818-957-7612
Fax Number : 818-957-3756
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 07/09/2007

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Directions to “ DR. GARY T. WECKBACHER D.C.” Practice Location

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