Individual
RICHARD P WIKHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
116 S PALISADE DR, STE 206, SANTA MARIA, CA 93454-8904
(805) 614-9250
(805) 614-9260
Mailing address
PO BOX 5427, SANTA MARIA, CA 93456-5427
(805) 614-6250
(805) 614-9260
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G55811
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G558110
—
CA
Enumeration date
07/14/2005
Last updated
10/01/2009
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