Individual
DR. ALVIN RAY WYATT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10666 N TORREY PINES RD # 100C, LA JOLLA, CA 92037-1027
(858) 554-2626
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(858) 249-6748
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
147190
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004739530002
—
KS
01
—
403000027
PTAN
KS
Enumeration date
07/16/2012
Last updated
03/19/2026
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