# BRENTON D. WYNN, MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598953960
- **Authorized official:** DR. BRENTON DAVID WYNN MEDICAL DOCTOR (OWNER /PRESIDENT OF CORPORATION)
- **Authorized official phone:** (619) 318-8233

## Contact information

- **Practice address:** 502 EUCLID AVE STE 200, NATIONAL CITY, CA 91950-2984
- **Practice address phone:** (619) 434-4019
- **Practice address fax:** (619) 461-5663
- **Mailing address:** 502 EUCLID AVE STE 200, NATIONAL CITY, CA 91950-2984
- **Mailing address phone:** (619) 434-4019
- **Mailing address fax:** (619) 461-5663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | A73257 | CA | Yes |

## Other

- **Enumeration date:** 10/10/2007
- **Last updated:** 07/19/2021