Provider Demographics
NPI:1437432283
Name:WARD, GENE ARLAN (MD)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:ARLAN
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8020 W MANCHESTER AVE
Mailing Address - Street 2:# 204
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7105
Mailing Address - Country:US
Mailing Address - Phone:310-968-5005
Mailing Address - Fax:310-670-7282
Practice Address - Street 1:8020 W MANCHESTER AVE
Practice Address - Street 2:# 204
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-7105
Practice Address - Country:US
Practice Address - Phone:310-968-5005
Practice Address - Fax:310-670-7282
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG21416208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology