Individual
DR. MICHAEL LEE WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5601 NORRIS CANYON RD, STE 100, SAN RAMON, CA 94583-5407
(925) 277-1055
(925) 277-1915
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(925) 277-1055
(925) 277-1915
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
006398000
CA
Other
Enumeration date
06/06/2006
Last updated
06/03/2020
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