Organization
P. PERRY WICH, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. P. PERRY WICH M.D. (PHYSICIAN)
(909) 946-3826
Entity
Organization
Contact information
Practice address
630 N 13TH AVE, SUITE F, UPLAND, CA 91786-4975
(909) 946-3826
(909) 949-4457
Mailing address
630 N 13TH AVE, SUITE F, UPLAND, CA 91786-4975
(909) 946-3826
(909) 949-4457
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A32660
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0002030
—
CA
Enumeration date
05/10/2007
Last updated
08/22/2020
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