| Gregory J Wiener M D Professional Corporation | |
|
353 Church Ave Ste A Chula Vista CA 91910-3906 | |
| (619) 585-8883 | |
| Not Available |
| Full Name | Gregory J Wiener M D Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 353 Church Ave Ste A, Chula Vista, California |
| Authorized Official Name and Position | Gregory James Wiener (PRESIDENT) |
| Authorized Official Contact | 6195858883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory J Wiener M D Professional Corporation 353 Church Ave Ste A Chula Vista CA 91910-3906 Ph: (619) 585-8883 | Gregory J Wiener M D Professional Corporation 353 Church Ave Ste A Chula Vista CA 91910-3906 Ph: (619) 585-8883 |
| NPI Number | 1376728287 |
|---|---|
| Provider Enumeration Date | 01/09/2008 |
| Last Update Date | 08/14/2015 |
| Medicare PECOS PAC ID | 6901983519 |
|---|---|
| Medicare Enrollment ID | O20080407000661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376728287 | NPI | - | NPPES |
| W22034 | Other | CA | MEDICARE GROUP PROVIDER |
| 00A417490 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A41749 (California) | Primary |
| Provider Name | Gregory J Wiener |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811099534 PECOS PAC ID: 9032126230 Enrollment ID: I20080407000654 |
| Provider Name | Patrick H Sweet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457407702 PECOS PAC ID: 6901103829 Enrollment ID: I20160321001230 |
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