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Individual
DR. GARY D WINES
Active
Individual
DR. GARY D WINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC015440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4294325
AETNA
CA
01
—
DC015440
BLUE SHIELD
CA
Enumeration date
06/20/2005
Last updated
08/02/2011
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