| Wondermed Of California, Inc | |
|
828 Crestmoore Pl Venice CA 90291-4931 | |
| (310) 692-1469 | |
| Not Available |
| Full Name | Wondermed Of California, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 828 Crestmoore Pl, Venice, California |
| Authorized Official Name and Position | Santino Labate (COMPLIANCE) |
| Authorized Official Contact | 9492016090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wondermed Of California, Inc 828 Crestmoore Pl Venice CA 90291-4931 Ph: (310) 692-1469 | Wondermed Of California, Inc 828 Crestmoore Pl Venice CA 90291-4931 Ph: (310) 692-1469 |
| NPI Number | 1639824105 |
|---|---|
| Provider Enumeration Date | 02/14/2022 |
| Last Update Date | 03/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639824105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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