Organization
WILBER & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE WATTLE (MEDICAL BILLING REP)
(209) 575-4575
Entity
Organization
Contact information
Practice address
1165 MONTGOMERY DR, PATHOLOGY DEPARTMENT, SANTA ROSA, CA 95405-4801
(209) 575-4575
Mailing address
PO BOX 4978, MODESTO, CA 95352-4978
(209) 575-4575
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0088940
—
CA
Enumeration date
05/28/2006
Last updated
01/29/2008
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