Individual
ERIK DOUGLAS WIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5000 SAN BERNARDINO ST, MONTCLAIR, CA 91763-2326
(909) 625-5411
Mailing address
5000 SAN BERNARDINO ST, MONTCLAIR, CA 91763-2326
(909) 625-5411
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20A17237
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/31/2017
Last updated
07/21/2022
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