Individual
CHRISTI LYNN WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17051 SIERRA LAKES PKWY, SUITE 101, FONTANA, CA 92336-1274
(909) 428-2040
(909) 428-2191
Mailing address
PO BOX 10488, SAN BERNARDINO, CA 92423-0488
(888) 344-9111
(909) 335-7130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A98378
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174760953
—
CA
05
—
1518136787
—
CA
05
—
1629231147
—
CA
01
—
A98378
CA MED LIC LICENSE
CA
Enumeration date
07/03/2008
Last updated
12/06/2021
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