Wickwire, William James

Wickwire, William James is an sole proprietor health care provider with primary practice located at 520 N Prospect Ave Ste 302, Redondo Beach CA 90277-3043. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Wickwire, William James can be contacted via phone (310) 798-1515.

Contact Information

Primary practice address
520 N Prospect Ave Ste 302 Redondo Beach CA 90277-3043
Phone: (310) 798-1515
Fax: (310) 798-3131
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G65083 California

Profile Details

NPI number 1699779660
LBN Legal business name Wickwire, William James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2005
Last updated Feb 21st, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699779660 NPPES
California MEDICAID 00G650830
California Other WG65083E

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