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Organization
JOHN MICHAEL WAITE, PHYSICIAN ASSISTANT, INC.
Active
Organization
JOHN MICHAEL WAITE, PHYSICIAN ASSISTANT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MICHAEL WAITE PA-C (PRESIDENT)
(310) 968-3123
Entity
Organization
Contact information
Practice address
3325 17TH ST, SANTA MONICA, CA 90405-5832
(310) 968-3123
Mailing address
3325 17TH ST, SANTA MONICA, CA 90405-5832
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
56135
CA
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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