Dontel D Wise, is a
Community Health Worker based in Grand Terrace, California. Dontel D Wise is licensed to practice in * (Not Available) (license number ) and his current practice location is
21935 Van Buren St Ste 13, Grand Terrace, California. He can be reached at his office (for appointments etc.) via phone at
(909) 906-1023.
NPI number for Dontel D Wise is 1316633019 and his current mailing address is 21935 Van Buren St Ste 1a, Grand Terrace, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1316633019.
Healthcare Provider's Profile
| Full Name | Dontel D Wise |
|---|
| Gender | Male |
|---|
| Speciality | Community Health Worker |
|---|
| Location | 21935 Van Buren St Ste 13, Grand Terrace, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1316633019
- Provider Enumeration Date: 04/14/2023
- Last Update Date: 09/25/2024
Medical Identifiers
Medical identifiers for Dontel D Wise such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316633019 | 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. Dontel D Wise 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 |
|---|
Dontel D Wise,
21935 Van Buren St Ste 1a,
Grand Terrace, CA 92313-5652
Ph: (909) 906-1023 | Dontel D Wise,
21935 Van Buren St Ste 13,
Grand Terrace, CA 92313-5624
Ph: (909) 906-1023 |
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