Dr Lisa Marie Wieler, MD | |
1100 Monterey St, Suite 210, San Luis Obispo, CA 93401-3102 | |
(805) 542-9700 | |
(805) 542-0584 |
Full Name | Dr Lisa Marie Wieler |
---|---|
Gender | Female |
Speciality | Radiology - Diagnostic Radiology |
Location | 1100 Monterey St, San Luis Obispo, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316011083 | NPI | - | NPPES |
CH9716 | Other | CA | CHAMPUS |
G46986 | Other | CA | LICENSE |
P00138584 | Other | CA | RAILROAD MEDICARE |
00G19230 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | G46986 (California) | Primary |
Entity Name | California Managed Imaging Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821271727 PECOS PAC ID: 9436229887 Enrollment ID: O20080528000575 |
Mailing Address | Practice Location Address |
---|---|
Dr Lisa Marie Wieler, MD 1100 Monterey St, Suite 210, San Luis Obispo, CA 93401-3102 Ph: (805) 542-9700 | Dr Lisa Marie Wieler, MD 1100 Monterey St, Suite 210, San Luis Obispo, CA 93401-3102 Ph: (805) 542-9700 |
Dr. Gary Martin Hatch, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1100 Monterey St, Suite 210, San Luis Obispo, CA 93401 Phone: 805-542-9700 Fax: 805-542-0584 | |
Dr. Archana C Lucchesi, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 6729 Monte Rd, San Luis Obispo, CA 93401 Phone: 858-546-3800 Fax: 858-546-3900 | |
Andy Hoang, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1100 Monterey St Ste 210, San Luis Obispo, CA 93401 Phone: 805-542-9700 | |
Dr. Jeffrey Kai Wu, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 100 Casa St Ste C, San Luis Obispo, CA 93405 Phone: 805-541-1932 Fax: 805-541-1653 | |
Dr. Michael Chervonski, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1010 Murray Ave, San Luis Obispo, CA 93405 Phone: 805-546-7600 | |
Robert D Henretig, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 2180 Johnson Ave, Ste A, San Luis Obispo, CA 93401 Phone: 805-269-1313 Fax: 805-269-1387 |