Organization
GREGORY J WIENER M D PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK H SWEET III MD (CEO)
(619) 204-6627
Entity
Organization
Contact information
Practice address
353 CHURCH AVE STE A, CHULA VISTA, CA 91910-3906
(619) 585-8883
Mailing address
353 CHURCH AVE STE A, CHULA VISTA, CA 91910-3906
(619) 585-8883
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A41749
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A417490
—
CA
01
—
W22034
MEDICARE GROUP PROVIDER
CA
Enumeration date
01/09/2008
Last updated
02/26/2025
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