MEDICARE: DR. MARK ALAN WARD MD

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	207Q00000X	Family Medicine Physician	A83686	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A836860	OTHER	CA	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639110257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK ALAN WARD MD

Provider Business Mailing Address
First Line	:	355 LAS VEGAS ST
Second Line	:
City	:	MORRO BAY
State	:	CA
Zip	:	93442-1548
Country	:	US
Telephone Number	:	805-772-7100
Fax Number	:	805-772-7776

Provider Business Practice Location Address
First Line	:	355 LAS VEGAS ST
Second Line	:
City	:	MORRO BAY
State	:	CA
Zip	:	93442-1548
Country	:	US
Telephone Number	:	805-772-7100
Fax Number	:	805-772-7776

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	04/30/2024

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