Provider Demographics
NPI:1669508982
Name:WARD, AARON SAMUEL (DC)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:SAMUEL
Last Name:WARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 PICO BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1078
Mailing Address - Country:US
Mailing Address - Phone:310-399-2220
Mailing Address - Fax:310-314-2787
Practice Address - Street 1:216 PICO BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-1078
Practice Address - Country:US
Practice Address - Phone:310-399-2220
Practice Address - Fax:310-314-2787
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0123030OtherCA BLUE SHIELD ID NUMBER
CADC0123030OtherCA BLUE SHIELD ID NUMBER
CADC12303Medicare ID - Type UnspecifiedSTATE LICENSE NUMBER