Individual
WAYNE T. DEWRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
10430 RHONDDA ST, REDLANDS, CA 92374-2881
(909) 796-8206
Mailing address
PO BOX 1918, LOMA LINDA, CA 92354-0599
(909) 799-7813
(909) 796-8973
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
PA 18316
CA
363A00000X
Physician Assistant
PA18316
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467584532
—
CA
Enumeration date
03/12/2007
Last updated
12/07/2009
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