Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A122511 | CA |
NPI | 1063701068 |
---|---|
Provider Name | Dr. Nicholas William Wettersten |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2011 |
Last Update Date | 13/06/2018 |