Individual
JAYSON WISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
375 N LA CIENEGA BLVD UNIT 325, WEST HOLLYWOOD, CA 90048-1956
(919) 274-8109
Mailing address
375 N LA CIENEGA BLVD UNIT 325, WEST HOLLYWOOD, CA 90048-1956
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A163300
CA
208D00000X
General Practice Physician
Primary
A163300
CA
Other
Enumeration date
03/26/2014
Last updated
10/07/2025
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