MEDICARE: DAVID WARDER CMT

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	225700000X	Massage Therapist	15547	CA

General Provider Information

NPI Number	:	1972947109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID WARDER CMT

Provider Business Mailing Address
First Line	:	4183 ADAMS AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-2537
Country	:	US
Telephone Number	:	619-269-9322
Fax Number	:

Provider Business Practice Location Address
First Line	:	4183 ADAMS AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-2537
Country	:	US
Telephone Number	:	619-786-3315
Fax Number	:

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

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	02/03/2026

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