Individual
CHRISTOPHER T WIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9888 GENESEE AVE, LA JOLLA, CA 92037-1205
(858) 626-6150
Mailing address
PO BOX 660997, ARCADIA, CA 91066-0997
(626) 447-0296
(626) 447-6057
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A88882
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A88882
MEDICAL LICENSE
CA
Enumeration date
07/27/2006
Last updated
12/16/2013
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