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Organization
MILLENNIUM MEDICAL ASSOCIATES INC.
Active
Organization
MILLENNIUM MEDICAL ASSOCIATES INC.
Active
Other names
Millennium Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DANIEL WIESNER (PRACTICE DIRECTOR)
(424) 285-5385
Entity
Organization
Contact information
Practice address
8641 WILSHIRE BLVD STE 100, BEVERLY HILLS, CA 90211-2919
(310) 360-5917
(424) 216-5783
Mailing address
8549 WILSHIRE BLVD STE 1248, BEVERLY HILLS, CA 90211-3104
(310) 360-5917
(424) 216-5783
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/31/2022
Last updated
10/20/2022
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