Individual
DR. JESSE RYAN WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
8700 BEVERLY BLVD, ROOM A903, WEST HOLLYWOOD, CA 90048-1804
(310) 423-5611
(310) 423-0412
Mailing address
8700 BEVERLY BLVD, ROOM A903, WEST HOLLYWOOD, CA 90048-1804
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
67195
CA
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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