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NPI Code Detail

MEDICARE: DR. GREGORY CLYDE BATES D.C.

MEDICARE:  DR. GREGORY CLYDE BATES  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
1111N00000XChiropractor14548CA

General Provider Information

NPI Number : 1528037066
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY CLYDE BATES D.C.
Provider Business Mailing Address
First Line : 28100 MODJESKA CANYON RD
Second Line :
City : SILVERADO
State : CA
Zip : 92676-9744
Country : US
Telephone Number : 714-544-9304
Fax Number : 714-710-9010
Provider Business Practice Location Address
First Line : 131 N TUSTIN AVE STE 104
Second Line :
City : TUSTIN
State : CA
Zip : 92780-2937
Country : US
Telephone Number : 714-544-3904
Fax Number : 714-710-9010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 10/05/2018

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Directions to “ DR. GREGORY CLYDE BATES D.C.” Practice Location

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