Provider Demographics
NPI:1497726798
Name:WARD, DAVID WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:WARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:957 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-2125
Mailing Address - Country:US
Mailing Address - Phone:619-575-4726
Mailing Address - Fax:619-532-6299
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:NMCSD, ATTN: MEDICAL STAFF SERVICES
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-6460
Practice Address - Fax:619-532-6299
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA16929111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician