Individual
ANDREW WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2450 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080-4356
(530) 527-0414
Mailing address
2450 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080-4356
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G42608
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089250
—
CA
05
—
RHM53955F
—
CA
Enumeration date
02/22/2007
Last updated
07/09/2007
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