Individual
MR. TYLER W WICHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
480 ALTA RD, SAN DIEGO, CA 92179-0001
(619) 661-6500
Mailing address
535 4TH ST, IMPERIAL BEACH, CA 91932-1201
(619) 646-4109
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
535868
CA
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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