Individual
MICHAEL LEE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 E CYPRESS STREET BLDG B, SANTA MARIA, CA 93454
(805) 922-7079
(805) 922-7970
Mailing address
1300 E. CYPRESS STREET, BLDG B, SANTA MARIA, CA 93454
(895) 922-8006
(805) 922-0184
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
G023298
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G023298
MEDICAL
CA
Enumeration date
08/12/2006
Last updated
01/20/2015
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