Individual
MARILYN A WIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12089 MERIDEN LN, SAN DIEGO, CA 92128-4339
(858) 405-8502
Mailing address
12089 MERIDEN LN, SAN DIEGO, CA 92128-4339
(858) 405-8502
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
244179
CA
Other
Enumeration date
06/20/2020
Last updated
11/27/2023
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