Individual
DR. BEATA ANNA WICHERSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 FLOWER ST STE A, GLENDALE, CA 91201-3000
(818) 637-2000
(818) 242-8761
Mailing address
1500 W WEST COVINA PKWY, STE 201, WEST COVINA, CA 91790-2703
(626) 263-7020
(626) 960-9177
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A53981
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A539810
—
CA
Enumeration date
05/05/2006
Last updated
04/14/2011
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