GLEN WISHON M.D. NPI 1447365150

NPI Information

Glen Wishon, M.D. is a family medicine in Redondo Beach, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Glen Wishon, M.D. NPI is 1447365150. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

520 N PROSPECT AVE STE 103
REDONDO BEACH, CA
ZIP 90277-033
Phone: (310) 376-8816
Fax: (310) 374-2806

The enumeration date for this NPI number is 8/20/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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