Individual
JONATHAN VANWICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 E CHURCH ST STE 101, SANTA MARIA, CA 93454-5915
(805) 925-2529
(805) 928-4478
Mailing address
1325 E CHURCH ST STE 101, SANTA MARIA, CA 93454-5915
(805) 925-2529
(805) 928-4478
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A183334
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
03/30/2018
Last updated
06/02/2023
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