# WENSLEY M KEITH MD, PC

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

## Provider details

- **NPI number:** 1790530004
- **Authorized official:** MICHAEL KEITH WENSLEY MD (CEO)
- **Authorized official phone:** (949) 467-9081

## Contact information

- **Practice address:** 1601 DOVE ST STE 170, NEWPORT BEACH, CA 92660-1421
- **Practice address phone:** (949) 467-9081
- **Practice address fax:** (209) 203-1036
- **Mailing address:** 1601 DOVE ST STE 170, NEWPORT BEACH, CA 92660-1421
- **Mailing address phone:** (949) 705-8226
- **Mailing address fax:** (209) 203-1036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/19/2024
- **Last updated:** 03/28/2025