Individual
DR. SHEILA GAYLE WIDYOLAR
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
23961 CALLE DE MAGDALENA, SUITE 403, LAGUNA HILLS, CA 92653-3664
(949) 452-3814
(949) 855-1007
Mailing address
23961 CALLE DE MAGDALENA, SUITE 403, LAGUNA HILLS, CA 92653-3664
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G25056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G250560
—
CA
Enumeration date
06/08/2005
Last updated
07/08/2007
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