Individual
CHERRY ANN WY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1144 COFFEE RD, MODESTO, CA 95355-4205
(209) 524-1211
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228
(191) 670-8803
(855) 202-9336
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A70518
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
A70518
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A70518
LICENSE
CA
Enumeration date
07/13/2006
Last updated
02/03/2022
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