Individual
DR. ELLEN A WIEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3301 C STREET, SUITE 550, SACRAMENTO, CA 95816
(916) 536-3200
(916) 235-2182
Mailing address
3400 DATA DRIVE, PHYSICIAN SUPPORT SERVICES, RANCHO CORDOVA, CA 95670-7956
(916) 379-2948
(916) 858-7065
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A105233
CA
2085R0203X
Therapeutic Radiology Physician
A105233
CA
Other
Enumeration date
11/05/2007
Last updated
09/25/2012
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