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Individual

MR. MICHAEL LEE WAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.N.

Contact information

Practice address
1302 EMDEN ST, WILMINGTON, CA 90744-4912
(310) 518-5572
Mailing address
1302 EMDEN ST, WILMINGTON, CA 90744-4912
(310) 518-5572

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
409904
CA

Other

Enumeration date
11/04/2008
Last updated
02/13/2013
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