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Organization
WILLIAM M WANSA MEDICAL GROUP
Active
Organization
WILLIAM M WANSA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM M WANSA MD (PRESIDENT)
(858) 352-6075
Entity
Organization
Contact information
Practice address
250 PROSPECT PL, CORONADO, CA 92118-1943
(619) 522-3722
Mailing address
PO BOX 28247, TEMPE, AZ 85285-8247
(480) 967-6500
(480) 967-6540
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
03/22/2011
Last updated
03/22/2011
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