Wynn, Brenton D
Wynn, Brenton D is an individual health care provider with primary practice located at 502 Euclid Ave Ste 200 , National City CA 91950-2984. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Wynn, Brenton D can be contacted via phone (619) 434-4019.Contact Information
Primary practice address
502 Euclid Ave Ste 200
National City CA 91950-2984
Phone: (619) 434-4019
Fax: (619) 461-5663
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | A73257 | California |
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | A73257 | California |
Profile Details
| NPI number | 1528069820 |
|---|---|
| LBN Legal business name | Wynn, Brenton D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Jun 24th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528069820 | NPPES |
| California | Other | W18884 | MEDICARE GROUP NUMBER |
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