Provider Demographics
NPI:1497770515
Name:WOOD, GREGORY GUY (DC/QME)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:GUY
Last Name:WOOD
Suffix:
Gender:M
Credentials:DC/QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 BRISTOL ST STE 130
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-8606
Mailing Address - Country:US
Mailing Address - Phone:714-437-9663
Mailing Address - Fax:714-437-9631
Practice Address - Street 1:1202 BRISTOL ST STE 130
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-8606
Practice Address - Country:US
Practice Address - Phone:714-437-9663
Practice Address - Fax:714-437-9631
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27192111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition