Individual
WESLEY MERRILL NOTTAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23961 CALLE DE LA MAGDALENA, SUITE 229, LAGUNA HILLS, CA 92653-3616
(949) 581-7001
Mailing address
22 ODYSSEY, STE 205, IRVINE, CA 92618-3186
(949) 586-3200
(949) 900-2136
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G29856
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3962518
BLUE CROSS #
CA
01
—
ZZZ38138Z
BLUE SHIELD #
CA
Enumeration date
05/17/2006
Last updated
12/08/2021
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