Organization
CRISTINA S. WIESE. M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRISTINA SUSANA WIESE M.D. (PRESIDENT)
(805) 557-0452
Entity
Organization
Contact information
Practice address
325 E. ROLLING OAKS DR., SUITE 100, THOUSAND OAKS, CA 91361-1283
(805) 557-0452
(805) 557-0471
Mailing address
325 E. ROLLING OAKS DR., SUITE 100, THOUSAND OAKS, CA 91361-1283
(805) 557-0452
(805) 557-0471
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A91425
CA
Other
Enumeration date
10/13/2010
Last updated
07/25/2012
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