Organization
WILKES FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNELLE MCDERMOTT (PRACTICE MANAGER)
(805) 499-4446
Entity
Organization
Contact information
Practice address
400 S REINO RD, SUITE 200, NEWBURY PARK, CA 91320-4284
(805) 499-4446
Mailing address
400 S REINO RD, SUITE 200, NEWBURY PARK, CA 91320-4284
(805) 499-4446
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
A85368
CA
332900000X
Non-Pharmacy Dispensing Site
A85368
CA
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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