Blair Wishom, is a
Community Health Worker based in Stockton, California. Blair Wishom is licensed to practice in * (Not Available) (license number ) and his current practice location is
2495 W March Ln Ste 125, Stockton, California. He can be reached at his office (for appointments etc.) via phone at
(209) 320-7675.
NPI number for Blair Wishom is 1316302532 and his current mailing address is 2495 W March Ln Ste 125, Stockton, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1316302532.
Healthcare Provider's Profile
| Full Name | Blair Wishom |
|---|
| Gender | Male |
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| Speciality | Community Health Worker |
|---|
| Location | 2495 W March Ln Ste 125, Stockton, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1316302532
- Provider Enumeration Date: 12/16/2015
- Last Update Date: 12/13/2023
Medical Identifiers
Medical identifiers for Blair Wishom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316302532 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blair Wishom is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Blair Wishom,
2495 W March Ln Ste 125,
Stockton, CA 95207-8224
Ph: (209) 320-7675 | Blair Wishom,
2495 W March Ln Ste 125,
Stockton, CA 95207-8224
Ph: (209) 320-7675 |
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